Colchicine poisoning in pediatric population: About one accidental case and literature review

Colchicine, an active alkaloid from the plant Colchicum, is used to treat gout and other inflammatory diseases such as familial Mediterranean fever. There is also evidence that colchicine may prove to be a useful adjunct to current therapy in the treatment of pericarditis. The authors present the death of a 4-year-old child, weighing 16 kg, who was administered for 2 consecutive days 8 mg of colchicine. There was a mistake in the dosage, introducing a confusion between 0.5 mg/day and 0.5 mg/kg/day. The toxicity of colchicine was increased by the concurrent prescription of azithromycin, a macrolide type antibiotic. After diarrheas and vomiting, the child collapsed with multiple visceral fatal failures. Tested by LC/MS-MS, the concentration of colchicine in peripheral blood was 14.7 ng/mL, with no apparent drug redistribution, as the cardiac blood was tested at 11.8 ng/mL. A high concentration was found in bile that tested positive at 348 ng/mL. Negative hair analysis documented the naive status of the child. A literature review has confirmed the un-frequent colchicine fatal poisonings in pediatric population in comparison with adults, irrespective of the manner of death, accidental, suicide or homicide. (C) 2015 Societe Francaise de Toxicologic, Analytique. Published by Elsevier Masson SAS. All rights reserved.