[Accidental fatal colchicine overdose]

Progress in the management of acute colchicine poisoning in adults

Colchicine is a tricyclic, lipid-soluble alkaloid which has long been used to treat gout and many immunological diseases. Due to its narrow therapeutic window and long half-life of elimination, colchicine overdose occurs occasionally. Unfortunately, some patients lost their lives because of colchicine overdose or suicide. Acute colchicine poisoning can lead to original gastrointestinal disorders, shock, progressive multiple organ failure, and myelosuppression. Although many researchers in the world performed lots of research, there are currently no specific antidotes for colchicine poisoning. Meanwhile, there are no management guidelines to treat patients with acute colchicine poisoning until now. Herein, we systematically elaborate on the clinical features and progress in the management of acute colchicine poisoning in adults according to the previous literature. This paper will provide some valuable and available information for clinicians.

Microtubule Organization Is Essential for Maintaining Cellular Morphology and Function

Microtubules (MTs) are highly dynamic polymers essential for a wide range of cellular physiologies, such as acting as directional railways for intracellular transport and position, guiding chromosome segregation during cell division, and controlling cell polarity and morphogenesis. Evidence has established that maintaining microtubule (MT) stability in neurons is vital for fundamental cellular and developmental processes, such as neurodevelopment, degeneration, and regeneration. To fulfill these diverse functions, the nervous system employs an arsenal of microtubule-associated proteins (MAPs) to control MT organization and function. Subsequent studies have identified that the disruption of MT function in neurons is one of the most prevalent and important pathological features of traumatic nerve damage and neurodegenerative diseases and that this disruption manifests as a reduction in MT polymerization and concomitant deregulation of the MT cytoskeleton, as well as downregulation of microtubule-associated protein (MAP) expression. A variety of MT-targeting agents that reverse this pathological condition, which is regarded as a therapeutic opportunity to intervene the onset and development of these nervous system abnormalities, is currently under development. Here, we provide an overview of the MT-intrinsic organization process and how MAPs interact with the MT cytoskeleton to promote MT polymerization, stabilization, and bundling. We also highlight recent advances in MT-targeting therapeutic agents applied to various neurological disorders. Together, these findings increase our current understanding of the function and regulation of MT organization in nerve growth and regeneration.

Colchicine overdose: A South African experience, a case report

Introduction

Colchicine overdose is uncommon but is associated with a high mortality rate. It has a narrow therapeutic index and has been described to have a 100% mortality with ingestion of >0.8 mg/kg (Finkelstein et al., 2010; Herran-Monge et al., 2013; Aghabiklooei et al., 2014; Erden et al., 2013).

Case report

This is a case report of a 19-year-old male who ingested 0.4 mg/kg of colchicine in a suicide attempt. He developed multiorgan dysfunction. He was managed supportively, and the dysfunction resolved.

Discussion

The clinical presentation and management should be familiar to all those who work in acute care in order to be able to identify and treat it timeously thus preventing morbidity and mortality. Treatment is largely supportive. To the best of our knowledge this is the first case of colchicine overdose described in Sub-Saharan Africa.