Colchicine Effect
Elizabeth A. Montgomery, MD
Key Facts
Terminology
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GI symptoms associated with mitotic arrest restricted to proliferative compartment of mucosa
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Best seen in small bowel and gastric antrum
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Clinical Issues
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Serum levels can be monitored clinically
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Colchicine has long half-life
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Patients with renal failure or liver disease most prone to toxicity
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Alkaloid
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Used to treat gout and many rheumatologic disorders
Microscopic Pathology
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Abundant mitotic figures arrested in metaphase (ring mitoses) restricted to proliferative compartment
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Apoptosis and atrophic villi
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Reactive epithelial changes
Hematoxylin & eosin shows a duodenal biopsy specimen from a patient with colchicine toxicity. There is crypt hyperplasia, mildly blunted villi, and many mitoses  in the proliferative compartment. |
Hematoxylin & eosin shows ring mitoses (mitotic arrest  ) in the mid-crypt portion of the duodenal mucosa. |
TERMINOLOGY
Synonyms
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Colchicine toxicity
Definitions
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GI symptoms associated with mitotic arrest restricted to proliferative compartment of mucosa
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Seen best in small bowel and gastric antrum
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Colchicine effect can be seen in neoplasms of patients taking therapeutic doses but only seen in normal mucosa when patients have toxic serum levels
CLINICAL ISSUES
Presentation
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Seen in patients taking colchicine
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Alkaloid
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Used to treat gout and many unrelated rheumatologic disorders
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Familial Mediterranean fever
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Binds to tubulin and inhibits formation of microtubules
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Thus inhibits degranulation, chemotaxis, mitosis, spermatogenesis
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Gastrointestinal manifestations of toxicity
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Cramping, abdominal pain, diarrhea
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