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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 26, Number 6, September 2002,
pp. 365-369
CASE REPORT: Application of LC–MS Analysis to a Colchicine
Fatality
Graham R. Jones, Peter P. Singer, and Bernard Bannach
Office of the Chief Medical Examiner, 7007 - 116 Street, Edmonton, Alberta,
Canada T6H 5R8
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-µm particle
size) and a programmed mobile phase consisting of 50mM pH 4 ammonium acetate
buffer and acetonitrile. Colchicine concentrations were as follows: 50 µg/L
in cardiac blood, 10 µg/L in vitreous humor, 575 µg/kg in liver,
12,000 µg/L in bile, and 4.4 µg 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.” Reproduction
of editorial content of this journal is prohibited without publisher’s
permission.
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