Clinical presentation

Colchicine poisoning can cause life-threatening multiorgan failure. The clinical features of poisoning occur in four stages:

• 2 to 12 hours after ingestion—vomiting and profuse diarrhoea causing dehydration, hypovolaemia, acute kidney injury, leucocytosis
• 24 hours to 7 days after ingestion—myocardial depression, arrhythmias, cardiovascular collapse, respiratory depression, metabolic acidosis, kidney failure, rhabdomyolysis, hypocalcaemia, neurotoxicity, consumptive coagulopathy, liver failure, death
• 5 to 10 days after ingestion—bone marrow suppression, most commonly severe neutropenia with increased risk of systemic infections and associated morbidity, but thrombocytopenia can also occur
• 10 or more days after ingestion—recovery, but possible alopecia and rebound leucocytosis.