From the Department of Pediatrics.
Department of Pediatric Critical Care Medicine.
Pediatr Emerg Care. 2022 Oct 1;38(10):489-493. doi: 10.1097/PEC.0000000000002835. Epub 2022 Aug 26.
Colchicine intoxication is rare but potentially fatal. The toxic dose of colchicine is not well established; it has been reported that major toxicity starts after doses of 0.5 mg/kg. We aimed to evaluate the demographic, clinical aspects, treatments, and outcome of colchicine toxicity cases in the pediatric intensive care unit (PICU).
We collected the data of patients aged between 0 and 18 years, admitted to Ankara University Faculty of Medicine PICU for colchicine poisoning (n = 22), from October 1999 to January 2020, retrospectively. Data extracted from the cases included age, sex, chronic condition, time between intake of drug and admission to PICU, source of drug, amount of drug ingested, other drug intake, symptoms, clinical findings, cardiac involvement, laboratory results, time of stay in PICU, treatment, and outcome.
Patients' age ranged from 7 months to 17 years. Median age was 86 months. The most common symptom at time of admission was vomiting, occurring in 13 (59%) of the patients. Two of the patients presented with change in mental status. Time between taking medication and applying to the hospital ranged from half an hour to 4 days. Medication intake of 3 of 22 patients was more than 0.5 mg/kg. One patient whose parents' best estimate of dose ingested was 0.48 mg/kg died because of the development of multiorgan failure. One patient who ingested 0.4 mg/kg of colchicine underwent plasma exchange and recovered without any complications.
Colchicine poisoning has a high risk of mortality, and death can be seen in doses less than a single acute dose of 0.5 mg/kg. These patients need close monitoring because there is always a risk of them to require aggressive support. Prognosis is poor in patients who have rapidly developing hemodynamic failure.
秋水仙碱中毒较为罕见，但可能致命。秋水仙碱的中毒剂量尚未明确；据报道，在摄入 0.5 毫克/千克的剂量后会出现严重毒性。本研究旨在评估儿科重症监护病房（PICU）中秋水仙碱中毒病例的人口统计学、临床特征、治疗方法和结局。
我们回顾性收集了 1999 年 10 月至 2020 年 1 月期间，因秋水仙碱中毒入住安卡拉大学医学院 PICU 的 0-18 岁患者的数据（n=22）。从病例中提取的数据包括年龄、性别、慢性疾病、摄入药物与入住 PICU 之间的时间、药物来源、摄入药物的剂量、其他药物摄入、症状、临床发现、心脏受累、实验室结果、在 PICU 中的停留时间、治疗方法和结局。
患者年龄为 7 个月至 17 岁，中位数为 86 个月。最常见的入院症状是呕吐，有 13 例（59%）患者出现该症状。有 2 例患者表现为精神状态改变。从服药到就诊的时间间隔为半小时至 4 天。22 例患者中有 3 例摄入药物的剂量超过 0.5 毫克/千克。1 例父母估计摄入剂量为 0.48 毫克/千克的患者因多器官衰竭而死亡。1 例摄入 0.4 毫克/千克秋水仙碱的患者接受了血浆置换治疗，且无任何并发症康复。
秋水仙碱中毒死亡率较高，甚至在低于单次急性 0.5 毫克/千克剂量时也会导致死亡。这些患者需要密切监测，因为他们始终有需要积极支持的风险。在迅速出现血流动力学衰竭的患者中，预后较差。
