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Acute poisoning with autumn crocus
(Colchicum autumnale L.).
Brvar M, Kozelj G, Mozina
M, Bunc M.
Poison Control Center, University Medical Center,
Ljubljana, Slovenia. miran.brvar@kclj.si
INTRODUCTION: Colchicum
autumnale, commonly known as the autumn crocus or meadow saffron,
contains the antimitotic colchicine, which binds to tubulin and prevents
it forming microtubules that are part of the cytoskeleton in all cells.
CASE REPORT: A 71-year-old woman ate a plant she thought to be wild
garlic (Allium ursinum). Ten hours later she arrived at the emergency
department complaining of nausea, vomiting and watery diarrhea.
Ingestion of a poisonous plant was suspected and she was treated with
gastric lavage, oral activated charcoal and an infusion of normal
saline. Toxicology analysis with gas chromatography and mass
spectrometry revealed colchicine in the patient's gastric lavage, blood
(5 microg/l) and urine (30 microg/l). She developed arrhythmias, liver
failure, pancreatitis, ileus, and bone marrow suppression with
pancytopenia. Alopecia began in the third week. Treatment was supportive
only. Five months later she had no clinical or laboratory signs of
poisoning. DISCUSSION: The patient mistakenly ingested autumn crocus
instead of wild garlic because of their great similarity. Colchicine
primarily blocks mitosis in tissues with rapid cell turnover; this
results in gastroenterocolitis in the first phase of colchicine
poisoning, bone marrow hypoplasia with pancytopenia in the second and
alopecia in the third, all of which were present in our patient.
Colchicine toxicity in tissues without rapid cell turnover caused
arrhythmias, acute liver failure and pancreatitis. CONCLUSION:
Colchicine poisoning can result in gastroenterocolitis followed by
multi-organ dysfunction syndrome. In unexplained gastroenterocolitis
after ingestion of wild plants as a salad or spice, especially when wild
garlic is mentioned, we should always consider autumn crocus. Diagnosis
could be confirmed only by toxicology analyses. Management of colchicine
poisoning is restricted to supportive therapy.
Publication Types:
PMID: 15088997 [PubMed - indexed for
MEDLINE]
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