Acute pancreatitis related to therapeutic dosing with colchicine: A case report

被引:4
作者
Ting J.Y.S. [1 ]
机构
[1] Department of Emergency Medicine, Mater Adult Hospital, South Brisbane, QLD 4101, Raymond Tce
关键词
Pancreatitis; Acute Pancreatitis; Colchicine; Gout; Nicorandil;
D O I
10.1186/1752-1947-1-64
中图分类号
学科分类号
摘要
Background: Colchicine is used in the treatment and prophylaxis of gout. It possesses a narrow therapeutic window, frequently resulting in dose-limiting gastrointestinal side-effects such as diarrhoea and emesis. As colchicine is a cellular anti-mitotic agent, the most serious effects include myelosuppression, myoneuropathy and multiple organ failure. This occurs with intentional overdose or with therapeutic dosing in patients with reduced clearance of colchicine due to pre-existing renal or hepatic impairment. Acute pancreatitis has rarely been reported, and only in association with severe colchicine overdose accompanied by multi-organ failure. Case presentation: We report a caseof acute pancreatitis without other organ toxicity related to recent commencement of colchicine for acute gout, occurring in an elderly male with pre-existing renal impairment. Conclusion: 1) Colchicine should be used with care in elderly patients or patients with impaired renal function. 2) Aside from myelosuppression, myoneuropathy and multiple organ failure, colchicine may now be associated with acute pancreatitis even with therapeutic dosing; this has not previously being reported. © 2007 Ting; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 14 条
[1]  
Terkeltaub R.A., Clinical practice, Gout N Engl J Med, 349, pp. 1647-1655, (2003)
[2]  
Teng G.G., Nair R., Saag K.G., Pathophysiology, clinical presentation and treatment of gout, Drugs, 66, pp. 1547-1563, (2006)
[3]  
Brvar M., Kozelj G., Mozina M., Bunc M., Acute poisoning with autumn crocus (Colchicum autumnale L.), Wien Klin Wochenschr, 116, pp. 205-208, (2004)
[4]  
Folpini A., Furfori P., Colchicine toxicity-clinical features and treatment. Massive overdose case report, J Toxicol Clin Toxicol, 33, pp. 71-77, (1995)
[5]  
Naidus R.M., Rodvien R., Mielke Jr. H., Colchicine toxicity: A mutisystem disease, Arch Intern Med, 137, pp. 394-396, (1977)
[6]  
Freeman J.S., Panebianco P.S., Colchicine overdosage: Report of a case, J Am Osteopath Assoc, 82, pp. 252-254, (1982)
[7]  
Clevenger C.V., August T.F., Shaw L.M., Colchicine poisoning: Report of a fatal case with body fluid analysis by GC/MS and histopathologic examination of postmortem tissues, J Anal Toxicol, 15, pp. 151-154, (1991)
[8]  
Whitcomb D.C., Acute pancreatitis, New Engl J Med, 354, pp. 2142-2150, (2006)
[9]  
Wilmink T., Frick T.W., Drug-induced pancreatitis, Drug Saf, 14, pp. 406-423, (1996)
[10]  
Draganov P., Forsmark C.E., Idiopathic" pancreatitis, Gastroenterology, 128, pp. 756-763, (2005)