IngentaConnect CASE REPORT: Application of LC?MS Analysis to a Colchicine Fatali...

Authors: Jones G.R.¹; Singer P.P.¹; Bannach B.¹

Source: Journal of Analytical Toxicology, Volume 26, Number 6, September 2002 , pp. 365-369(5)

Abstract:

A 73-year-old man developed nausea, vomiting, and diarrhea 20?30 min after receiving a 1.0 mg intravenous dose of colchicine for the treatment of severe pain due to gouty arthritis in his physician's office. He was hospitalized 8 h later, and his condition deteriorated as he developed renal and respiratory failure. He subsequently died 10 h later, or a total of 18 h after he received the original 1 mg colchicine injection. The patient received a prescription for oral 0.6 mg colchicine tablets 8 days previously and consumed eight tablets during that period, an average of 0.6 mg/day (42 of 50 tablets remained at the time of death). Colchicine concentrations were measured by liquid chromatography–mass spectrometry in selected ion monitoring mode using positive ionization. Chromatography was performed using an Eclipse XDB C8 analytical column (30 mm x 2.1-mm i.d., 3–m particle size) and a programmed mobile phase consisting of 50mM pH 4 ammonium acetate buffer and acetonitrile. Colchicine concentrations were as follows: 50 g/L in cardiac blood, 10 g/L in vitreous humor, 575 g/kg in liver, 12,000 g/L in bile, and 4.4 g in 60 g received gastric contents (estimated total gastric contents 100 g). The cause of death was ruled to be "acute colchicine toxicity" and the manner of death "accidental."

Language: English

Document Type:

Affiliations: 1: Office of the Chief Medical Examiner, 7007 - 116 Street, Edmonton, Alberta, Canada T6H 5R8

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CASE REPORT: Application of LC?MS Analysis to a Colchicine Fatality