Fatal colchicine poisoning by accidental ingestion of meadow saffron-case report

• Published in: Forensic science international Vol. 149; no. 2; pp. 253 - 256
• Main Authors: Sundov, Zeljko, Nincevic, Zeljko, Definis-Gojanovic, Marija, Glavina-Durdov, Merica, Jukic, Ivana, Hulina, Nada, Tonkic, Ante
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ireland Ltd 10.05.2005; Elsevier; Elsevier Limited
• Subjects: Accidents; Allium ursinum; Biological and medical sciences; Colchicine - poisoning; Colchicine accidental poisoning; Colchicum - poisoning; Colchicum autumnale; Diarrhea; Fatalities; Forensic Medicine; Forensic sciences; General aspects; Humans; Investigative techniques, diagnostic techniques (general aspects); Laboratory; Male; Medical sciences; Middle Aged; Oliguria - chemically induced; Pathology; Plant Leaves - poisoning; Proteins; Respiratory Insufficiency - chemically induced; Spleen; Pathology; Laboratory; Colchicum autumnale; Colchicine accidental poisoning; Hypouricemic agent; Forensic science; Oral administration; Forensic aspect; Accidental error; Ingestion; Case study; Anatomic pathology; Death; Poisoning; Colchicine
• ISSN: 0379-0738; 1872-6283
• DOI: 10.1016/j.forsciint.2004.06.034

A 62-year-old male died of colchicine poisoning after accidental ingestion of Colchicum autumnale (meadow saffron). He ate a salad of plant with green leaves regarded as wild garlic ( Allium ursinum). A few hours later he developed symptoms of gastroenteritis and was admitted to hospital. In spite of gastric lavage, activated charcoal and supportive measures, multi-organ system failure developed over the next two days. Laboratory analysis showed highly elevated blood concentrations of hepatic enzymes, creatine kinase, lactate dehydrogenase and blood urea nitrogen, as well as leukocytopenia and thrombocytopenia. Mechanical ventilation, dopamine, noradrenaline, crystalloid solutions and fresh frozen plasma were applied but despite treatment the patient died five days after the ingestion. Post-mortem examination revealed hepatic centrilobular necrosis, nephrotoxic acute tubular necrosis, petechial bleeding in fatty tissue, blunt and shortened intestinal villi and cerebral toxic edema. Botanical identification of incriminated plant gave Colchicum autumnale which confirmed colchicine poisoning. Although the accidental ingestion of Colchicum autumnale is rare and to our knowledge only five such cases have been described in detail, this is the second fatal case in Croatia described in the last 3 years.