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自杀未遂后出现严重高甘油三酯血症和秋水仙碱中毒。

Severe hypertriglyceridemia and colchicine intoxication following suicide attempt.

作者信息

Lev Shaul, Snyder David, Azran Carmil, Zolotarsky Victor, Dahan Arik

机构信息

Intensive Care Unit, Rabin Medical Center, Petah-Tikva.

Sackler School of Medicine NY/American Program, Tel-Aviv University, Tel Aviv.

出版信息

Drug Des Devel Ther. 2017 Nov 22;11:3321-3324. doi: 10.2147/DDDT.S140574. eCollection 2017.

DOI:10.2147/DDDT.S140574
PMID:29200827
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5702170/
Abstract

Colchicine overdose is uncommon but potentially life threatening. Due to its serious adverse systemic effects, overdose must be recognized and treated. We report a case of an 18-year-old female who ingested 18 mg (~0.4 mg/kg) of colchicine in a suicide attempt. The patient's clinical manifestations included abdominal cramps, vomiting, pancytopenia, hypocholesterolemia, and rhabdomyolysis. Two unique manifestations of toxicity in this patient were profound and persistent, severe hypertriglyceridemia and electrolyte imbalance, mainly hypophosphatemia, with no other evident cause except the colchicine intoxication. Following intensive supportive treatment, including ventilator support, N-acetylcysteine, granulocyte colony stimulating factor, electrolyte repletion, and zinc supplementation, the patient made a complete recovery. Colchicine intoxication is a severe, life-threatening situation that should be followed closely in intensive care units. Severe changes in body functions can rapidly develop, as previously described in the literature. To our knowledge, this extremely elevated triglyceride level has never been reported without the administration of propofol, and requires further evaluation.

摘要

秋水仙碱过量并不常见,但可能危及生命。由于其严重的全身性不良反应,必须识别并治疗过量情况。我们报告一例18岁女性自杀未遂,摄入18毫克(约0.4毫克/千克)秋水仙碱的病例。患者的临床表现包括腹部绞痛、呕吐、全血细胞减少、低胆固醇血症和横纹肌溶解。该患者中毒的两个独特表现是严重且持续的重度高甘油三酯血症和电解质失衡,主要是低磷血症,除秋水仙碱中毒外无其他明显原因。经过强化支持治疗,包括呼吸机支持、N-乙酰半胱氨酸、粒细胞集落刺激因子、补充电解质和锌,患者完全康复。秋水仙碱中毒是一种严重的、危及生命的情况,应在重症监护病房密切监测。身体功能的严重变化可能迅速发展,如文献中先前所述。据我们所知,在未使用丙泊酚的情况下,从未报告过如此极高的甘油三酯水平,需要进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248a/5702170/230670b73a9a/dddt-11-3321Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248a/5702170/ae2696b1fcb2/dddt-11-3321Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248a/5702170/230670b73a9a/dddt-11-3321Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248a/5702170/ae2696b1fcb2/dddt-11-3321Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248a/5702170/230670b73a9a/dddt-11-3321Fig2.jpg

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Am J Clin Nutr. 2011 Jun;93(6):1356-64. doi: 10.3945/ajcn.110.008417. Epub 2011 Apr 27.
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Multiple organ failure after an overdose of less than 0.4 mg/kg of colchicine: role of coingestants and drugs during intensive care management.
Rheumatology (Oxford). 2024 Apr 2;63(4):936-944. doi: 10.1093/rheumatology/kead625.
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Intern Emerg Med. 2022 Oct;17(7):2069-2081. doi: 10.1007/s11739-022-03079-6. Epub 2022 Aug 26.
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Immunomodulatory agents for COVID-19 treatment: possible mechanism of action and immunopathology features.COVID-19 治疗的免疫调节剂:可能的作用机制和免疫病理学特征。
Mol Cell Biochem. 2022 Mar;477(3):711-726. doi: 10.1007/s11010-021-04325-9. Epub 2022 Jan 11.
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Severe Colchicine Intoxication: A Case Report and Review of Literature in Adults.严重秋水仙碱中毒:一例成人病例报告及文献综述
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