Severe colchicine intoxication in a renal transplant recipient on cyclosporine

Transplant Proc. 2012 Nov;44(9):2851-2. doi: 10.1016/j.transproceed.2012.09.028.

Abstract

Using colchicine to treat an acute gout crisis in an organ transplant recipient (TR) on cyclosporine (CsA) may result in life-threatening intoxication. We report the case of a 59-year-old kidney transplant recipient on CsA who was treated with colchicine for acute gout crisis. Seven days later, he developed rhabdomyolysis with progressive quadriparesis, hematologic toxicity and acute renal failure. CsA inhibits P-glycoprotein resulting in decreased hepatic metabolism and renal excretion of colchicine. Colchicine and CsA withdrawal as well as appropriate supportive treatments were effective to manage all of these complications.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / therapy
  • Atorvastatin
  • Colchicine / adverse effects*
  • Colchicine / metabolism
  • Cyclosporine / adverse effects*
  • Drug Interactions
  • Gout / drug therapy*
  • Gout / etiology
  • Gout Suppressants / adverse effects*
  • Gout Suppressants / metabolism
  • Heptanoic Acids / adverse effects
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Immunosuppressive Agents / adverse effects*
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Pyrroles / adverse effects
  • Quadriplegia / chemically induced
  • Quadriplegia / therapy
  • Rhabdomyolysis / chemically induced
  • Rhabdomyolysis / therapy
  • Treatment Outcome

Substances

  • Gout Suppressants
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Immunosuppressive Agents
  • Pyrroles
  • Cyclosporine
  • Atorvastatin
  • Colchicine