Myoedema: a forgotten sign in acute colchicine myopathy

Colchicine myopathy typically presents acutely to subacutely with progressive limb weakness. The patients may not be on high doses of colchicine but almost always have acute kidney injury. Dehydration from colchicine-induced diarrhoea is often a precipitating factor. The concomitant neurotoxicity ma...

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Published inBMJ case reports Vol. 16; no. 10; p. e257076
Main Authors Le Tri, Si, Nguyen Vinh, Khang, Dang, Tinh Quang, Umapathi, Thirugnanam
Format Journal Article
LanguageEnglish
Published London BMJ Publishing Group LTD 10.10.2023
BMJ Publishing Group
Subjects
Arthritis
Biopsy
Blood tests
Case reports
Cell division
Creatinine
Diabetes
Diarrhea
Edema
Guillain-Barre syndrome
Hypothyroidism
Kidney diseases
Kinases
Muscle strength
Neurology
Patients
Thyroid gland
Toxicity
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Summary:Colchicine myopathy typically presents acutely to subacutely with progressive limb weakness. The patients may not be on high doses of colchicine but almost always have acute kidney injury. Dehydration from colchicine-induced diarrhoea is often a precipitating factor. The concomitant neurotoxicity may produce mild sensory complaints. This combination of acute neurological symptoms preceded by diarrhoea prompts the diagnosis of Guillain-Barre syndrome (GBS). The absence of cranial nerve deficits, raised creatine kinase and myotonic discharges on electromyogram may help in differentiating this condition from GBS. We describe a clinical sign, myoedema — a mounding phenomenon of muscle that is elicited by percussion and resolves when the patient recovers. It aids in the bedside diagnosis of acute colchicine myopathy as well as distinguish it from other more common causes of acute flaccid paralysis. We also discuss the possible mechanism of colchicine toxicity and the mounding phenomenon.
Bibliography:ObjectType-Case Study-2
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ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2023-257076