Severe colchicine poisoning treated successfully with kidney replacement therapy and plasmapheresis: a case report

Figures & data

Table 1. Selected laboratory values of patient.

		Time Since Ingestion (Hours), Time and Date
	Reference Values	18 h*	27 h	38 h	50 h	57 h	78 h	124 h	169 h
Laboratory Values
Sodium (mmol/L)	136 − 145	140	137	135	133	133	135	135	139
Carbon Dioxide (mmol/L)	22 − 31	24	17	19	18	13	21	22	23
Anion Gap	7 − 17	14	16	13	13	22	13	10	12
BUN (mg/dL)	6 − 23	12	18	14	11	12	10	14	27
Creatinine (mg/dL)	0.50 − 1.20	1.12	1.51	1.35	1.17	1.47	1.06	1.09	0.81
AST (SGOT) (U/L)	10 − 50	150	234	251	282	138	370	258	183
ALT (SGPT) (U/L)	15 − 41	42	78	72	64	35	144	209	166
CK (U/L)	39 − 308	716	–	2278	4624	2508	3756	1398	2384
High-sensitivity troponin T (ng/L)	0 − 14	16	–	–	–	2055	–	–	–
Lactic Acid (mmol/L)	0.2 − 2.0	7.1	3.2	4.8	3.3	7.7	4.2	1.5	0.9
WBC (K/µL)	4.00 − 10.00	32.98	19.22	14.86	13.18	10.37	7.00	4.46	10.34
Hgb (g/dL)	13.5 − 18.0	18.3	14.7	11.9	10.3	9.8	8.8	7.6	7.3
PLT(K/µL)	150 − 450	264	103	57	28	53	50	98	42
Absolute Neutrophil Count (K/µL)	1.92 − 7.6	26.71	13.84	12.63	10.02	9.23	6.23	2.72	6.41
Absolute Lymphocyte Count (K/µL)	0.72 − 4.10	2.97	1.73	0.30	0.53	0.00	0.35	0.40	1.03
PT-INR	0.9 − 1.1	1.5	3.3	4.1	2.4	1.5	1.3	1.2	1.3
Fibrinogen (mg/dL)	200 − 450	–	–	137	290	210	325	256	302
D-dimer (ng/mL)	< 500	–	–	>4000	>4000	>4000	>4000	–	>4000
EKG Parameters		11/7 12:40		11/8 02:20	11/8 17:51		11/9 17:37	11/11 03:10	11/13 03:59
QRS (ms)	< 120	88	–	88	114	–	108	98	110
QTc (ms)	< 430	436	–	452	459	–	424	520	444

Table Legend. ALT, alanine aminotransferase; AST, aspartate transaminase; BUN, blood urea nitrogen; CK, creatine kinase; Hgb, hemoglobin; INR, international normalized ratio; PLT, platelets; PT, prothrombin time; QTc, corrected QT interval; WBC, white blood cells; *Ingestion occurred at 2PM on the day prior to presentation to the emergency department. The patient presented to the emergency department at 7AM, approximately 17 h since ingestion.

Figure 1. Available colchicine concentrations. The patient presented at approximately 17 h after ingestion and serum colchicine concentrations were first obtained at hour 30. Continuous kidney replacement therapy was performed for 7 days beginning at hour 27. Three cycles of plasmapheresis were performed beginning at hour 51.