Abstract
Colchicine is recommended as daily prophylactic therapy in patients with familial mediterranean fever (FMF) to prevent febrile paroxysms. The drug is known to be a potent inhibitor of mitotic activity and might therefore be expected to have a significant adverse effect on tissues that undergo rapid turnover. We studied small bowel biopsies from nine patients with FMF who were receiving daily low-dose oral colchicine therapy. In each patient the lengths of 20 crypts and villi were measured and the number of mitotic figures in 20 crypts were counted. The data were compared with similar measurements from histologically normal-appearing biopsies obtained from 14 patients with a variety of mild gastrointestinal complaints. The mean crypt length was found to be significantly greater (0.197 mm vs 0.186 mm,P<0.0001) and the mean villous length significantly smaller (0.369 mm vs. 0.442 mm,P<0.0001) in the FMF patients than in the control population. In addition, the mean number of mitotic figures per crypt was significantly higher in the FMF patients (2.58 vs 1.00,P<0.001). The data reveal a pattern of mucosal injury in the colchicine-treated FMF patients characterized by a hyperplastic crypt-villous atrophy pattern with increased mitotic rate, which is indicative of an increase in cell turnover and opposite to what we anticipated based on colchicine's known effect on mitotic activity.
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References
Zemer D, Revach M, Mordechai P, Modan B, Schor S, Sohar E, Gafni J: Controlled trial of colchicine in preventing attacks of familial Mediterranean fever. N Engl J Med 291:932–934, 1974
Dinarello CA, Wolff SM, Goldfinger SE, Dale DC, Alling DW: Colchicine therapy for familial Mediterranean fever—a double-blind trial. N Engl J Med 291:934–937, 1974
Goldstein RC, Schwabe AD: Prophylactic colchicine therapy in familial Mediterranean fever—a controlled, double-blind study. Ann Intern Med 81:792–794, 1974
Eliakim M, Levy M, Ehrenfeld M: Recurrent polyserositis (familial Mediterranean fever, periodic disease). Amsterdam, Elsevier/North Holland Medical Press, 1981
Zemer D, Pras M, Sohar E, Gafni J: Colchicine in familial Mediterranean fever. N Engl J Med 294:170–171, 1976 (letter)
Levy M, Eliakim M: Long0term colchicine prophylaxis in familial Mediterranean fever. Br Med J 24:808, 1977
Bakir F: Periodic peritonitis. Present management and future prospects. Arch Intern Med 139:781–783, 1979
Peters RS, Lehman TJA, Schwabe AD: Colchicine use for familial Mediterranean fever. Observations associated with long-term treatment. West J Med 138:43–46, 1983
Merlin HE: Azoospermia caused by colchicine. A case report. Fertil Steril 23:180–181, 1972
Race TF, Paes IC, Faloon WW: Intestinal malabsorption induced by oral colchicine. Am J Med Sci 259:32–41, 1970
Webb DI, Chodos RB, Mahar CQ, Faloon WW: Mechanism of vitamin B12 malabsorption in patients receiving colchicine. N Engl J Med 279:845–850, 1968
Brandborg LL, Rubin CE, Quinton WE: A multipurpose instrument for suction biopsy of the esophagus, stomach, small bowel and colon. Gastroenterology 37:1–16, 1959
Yu TF, Gutman AB: Efficacy of colchicine prophylaxis in gout. Prevention of recurrent gouty arthritis over a mean period of five years in 208 gouty subjects. Ann Intern Med 55:179–192, 1961
Bremner WJ, Paulsen CA: Colchicine and testicular function in man. N Engl J Med 294:1384–1385, 1976
Cohen MM, Levy M, Eliakim M: A cytogenetic evaluation of long-term colchicine therapy in the treatment of familial Mediterranean fever (FMF). Am J Med Sci 274:147–152, 1977
Shiner M, Doniach I: Histopathologic studies in steatorrhea. Gastroenterology 38:419–440, 1960
Ehrenfeld M, Levy M, Sharon P, Rachmilewitz D, Eliakim M: Gastrointestinal effects of long-term Colchine therapy in patients with recurrent polyseositis (familial Mediterranean fever). Dig Dis Sci 27:723–726, 1982
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Hart, J., Lewin, K.J., Peters, R.S. et al. Effect of long-term colchicine therapy on jejunal mucosa. Digest Dis Sci 38, 2017–2021 (1993). https://doi.org/10.1007/BF01297078
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DOI: https://doi.org/10.1007/BF01297078