Gilbert J D, Byard R W
Forensic Science Center, 21 Divett Place, Adelaide 5000, SA, Australia.
Forensic Sci Int. 2002 Apr 18;126(2):150-2. doi: 10.1016/s0379-0738(02)00047-6.
Following ingestion of 30 mg of presumed benztropine (Cogentin) a 39-year-old male developed nausea, vomiting and diarrhea. His admission to hospital was soon followed by collapse and death. Histological examination, however, revealed increased numbers of mitotic figures in otherwise normal epithelial cells of the esophagus and bronchioles, a feature characteristic of colchicine toxicity. Subsequent toxicological analyses confirmed the presence of colchicine in the urine, but not in the blood. A dispensing error had resulted in substitution of colchicine for Cogentin. Histological findings had, therefore, provided evidence of colchicine toxicity and had guided subsequent toxicological evaluation. In suspected cases of colchicine toxicity, histological samples should, therefore, be taken from multiple sites along the gastrointestinal and respiratory tract in addition to other organs and tissues so that diagnostic morphological changes can be looked for.
一名39岁男性摄入30毫克疑似苯海索（安坦）后，出现恶心、呕吐和腹泻。他入院后不久便出现虚脱并死亡。然而，组织学检查显示，在食管和细支气管原本正常的上皮细胞中，有丝分裂图像数量增加，这是秋水仙碱中毒的特征性表现。随后的毒理学分析证实尿液中存在秋水仙碱，但血液中未检测到。一次配药错误导致将秋水仙碱误作苯海索配发给患者。因此，组织学检查结果提供了秋水仙碱中毒的证据，并指导了后续的毒理学评估。所以，在疑似秋水仙碱中毒的病例中，除了其他器官和组织外，还应从胃肠道和呼吸道的多个部位采集组织学样本，以便寻找诊断性的形态学变化。
