急性摄入秋水仙碱后发生致命性心血管虚脱。
Fatal cardiovascular collapse following acute colchicine ingestion.
作者信息
Mullins M E, Carrico E A, Horowitz B Z
机构信息
Oregon Poison Center, Oregon Health Sciences University, Portland, USA.
出版信息
J Toxicol Clin Toxicol. 2000;38(1):51-4. doi: 10.1081/clt-100100916.
BACKGROUND
A previously published prognostic rule predicts 100% survival after ingestion of cochicine doses less than 0.5 mg/kg and 100% mortality after ingestion of more than 0.8 mg/kg. This rule inaccurately predicted survival in a recent case.
CASE REPORT
We present a case of fatal colchicine poisoning in an adult who ingested a maximum of 39.6 mg of colchicine (0.40 mg/kg). He subsequently developed hypotension which was refractory to fluid resuscitation and infusion of vasopressors. He died of cardiovascular collapse approximately 35 hours after ingestion.
DISCUSSION
Fatal outcomes are possible even with colchicine doses less than 0.5 mg/kg. Physicians caring for colchicine-poisoned patients must be prepared for the possibility of acute cardiovascular collapse and ventricular dysrhythmias regardless of the reported dose of colchicine.
背景
先前发表的一项预后规则预测，摄入秋水仙碱剂量低于0.5mg/kg时生存率为100%，摄入超过0.8mg/kg时死亡率为100%。该规则在最近一个病例中对生存情况的预测并不准确。
病例报告
我们报告一例成年患者秋水仙碱中毒致死的病例，该患者摄入的秋水仙碱最大量为39.6mg（0.40mg/kg）。随后他出现低血压，液体复苏和使用血管加压药均无效。摄入后约35小时，他死于心血管衰竭。
讨论
即使秋水仙碱剂量低于0.5mg/kg，也可能出现致命后果。治疗秋水仙碱中毒患者的医生必须做好准备，无论报告的秋水仙碱剂量如何，都要应对急性心血管衰竭和室性心律失常的可能性。
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