Protocol Overview The meadow saffron often called an autumn-blooming crocus is the source of Colchicine, and is used as an herbal treatment of gout. Early signs of poisoning include burning feeling in mouth, difficulty swallowing, and intense thirst. Ingestion of colchicine typically leads to profuse vomiting and diarrhea, which can be bloody, severe abdominal pain and paralysis, followed by hypovolemic shock and multisystem organ failure within 24-72 hours.

1. Colchicine
BY SREEREMYA.S

2.  Protocol Overview
 The meadow saffron often called an autumn-blooming
crocus is the source of Colchicine, and is
 used as an herbal treatment of gout. Early signs of
poisoning include burning feeling in mouth,
 difficulty swallowing, and intense thirst. Ingestion of
colchicine typically leads to profuse vomiting
 and diarrhea, which can be bloody, severe
abdominal pain and paralysis, followed by
 hypovolemic shock and multisystem organ failure
within 24-72 hours.

3.  Coma, convulsions, and
 sudden death might also occur. Subsequent
complications include bone marrow suppression
with
 resultant leukopenia, thrombocytopenia (nadir in
4-7 days), and possibly sepsis

4.  Colchicine can be detected in urine or plasma
using liquid extraction followed by liquid
 chromatography tandem mass spectrometry
techniques. Environmental and food specimens
 involve additional extraction and pre-concentration
steps prior to analysis by
chromatographic
 mass spectrometry.

5.  Specimens
 Please reference the CT Specimen Collection Chart for more
detailed information.
 a. Clinical testing rapid toxicological screen: urine (all patients)
 • Collect at least 50 mL in a screw-capped plastic container, preferably
clean catch. Do not
 overfill. Note on documentation any collection method other than clean
catch.
 • Freeze as soon as possible (−70°C or dry ice preferred).
 • Ship urine samples frozen on dry ice, store at -70°C.
 • For each lot number of containers used for collection, provide two
empty unopened
 containers.
 Refer to DPHL’s “CDC Specimen-Collection Protocol for a Chemical-
Exposure Event” for
 more detailed directions on clinical collection, handling, packaging and
shipping.

6.  Environmental and food testing: LC/MS/MS (consult
referral laboratory for details).
 • Specimens will be referred to a FERN-C (food) or
ERLN (environmental) reference
 laboratory for further testing.
 • Collect minimum 2 teaspoons of liquid into a clear,
certified glass container.
 • Collect a minimum 2 teaspoons of solid into a 50 mL
plastic centrifuge tube.
 • For each lot number of containers used for
collection, provide two empty unopened
 containers