Skip to main content
SpringerLink
Log in

Gastrointestinal effects of long-term colchicine therapy in patients with recurrent polyserositis (familial Mediterranean fever)

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Twelve patients with recurrent polyserositis (RP, familial Mediterranean fever) on colchicine prophylaxis (1.0–2.0 mg daily) for three years or more were evaluated for the presence of gastrointestinal effects possibly attributable to the drug. Two patients had bulky stools, two others had transient diarrhea, and one had heartburn. Serum vitamin B12, calcium, and carotene levels were normal in all cases, andd-xylose absorption was normal in 11 of the 12. Three patients had mild steatorrhea (7.5, 7.9, and 9.9 g daily). Jejunal biopsies from these and a fourth patient with bulky stools but normal fecal fat excretion showed no abnormal histological changes. However, (Na+K)-ATPase activity was significantly decreased in all four cases. Colchicine had to be discontinued in only one of the 12 cases. It is concluded that mild steatorrhea and enzyme inhibition may occur in patients on long-term colchicine prophylaxis and that careful periodic observations for this and other adverse effects is imperative in such patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Shanbrom E, Raporport L: Gastrointestinal complications of colchicine therapy in gout. Ann Intern Med 48:655–660, 1958

    PubMed  Google Scholar 

  2. Race TF, Paes IC, Faloon WW: Intestinal malabsorption by oral colchicine. Clin Res 14:480, 1966

    Google Scholar 

  3. Gaultier M, Kaufer A, Bismuth C: Donnees actuelles sur l'intoxication aigue par la colchicine. Ann Med Interne 120:605–618, 1969

    Google Scholar 

  4. Race TF, Paes IC, Faloon WW: Intestinal malabsorption induced by oral colchicine. Comparison with neomycin and carthartic agents. Am J Med Sci 259:32–41, 1970

    PubMed  Google Scholar 

  5. Stemmerman GN, Hayashi T: Colchicine intoxication: A reappraisal of its pathology based on a study of three fatal cases. Hum Pathol 2:321–328, 1971

    PubMed  Google Scholar 

  6. Heany D, Derghazarian CB, Pineo GF, Ali MAM: Massive colchicine overdose: A report on the toxicity. Am J Med Sci 271:233–238, 1976

    PubMed  Google Scholar 

  7. Clark PA, Harland WA: Experimental malabsorption with jejunal atrophy induced by colchicine. Br J Exp Pathol 44:520–523, 1963

    PubMed  Google Scholar 

  8. Luketic GC, Shapiro M: Effect of colchicine on xylose absorption in dogs. Clin Res 1:31, 1964

    Google Scholar 

  9. Luketic GC, Myren J, Sachs G, Hirschowitz BI: Effect of therapeutic doses of colchicine on oxidative enzymes in the intestine. Nature 202:608–609, 1964

    PubMed  Google Scholar 

  10. Levin RJ: Effect of colchicine on intestinal function in the rat. Gut 7:250–257, 1966

    PubMed  Google Scholar 

  11. Myren J, Luketic GC, Ceballos R, Sachs G, Hirschowitz BI: Effects of colchicine on intestinal mucosal dehyrogenases. 1. Histochemical observations. Am J Dig Dis 11:394–403, 1966

    PubMed  Google Scholar 

  12. Fredricsson B, Wirsén C:In vivo effect of colchicine on alkaline phosphates of rat intestinal epithelium. Exp Cell Res 10:749–751, 1957

    Google Scholar 

  13. Luketic GC, Sachs G, Myren J, Tsuji T, Hirschowitz BI: Effects of colchicine on intestinal mucosal dehydrogenases. II. Biochemical observations. Am J Dig Dis 11:404–409, 1966

    PubMed  Google Scholar 

  14. Herbst JJ, Hurwitz R, Sunshine P, Kretchmer N: Effect of colchicine on intestinal disaccharidases: Correlation with biochemical aspects of cellular renewal. J Clin Invest 49:530–536, 1970

    PubMed  Google Scholar 

  15. Cohen MI, McNamara H: The effect of colchicine on guineapig intestinal enzyme activity. Am J Dig Dis 15:247–250, 1970

    PubMed  Google Scholar 

  16. Dinarello CA, Wolff SM, Goldfinger SE, Dale DC, Alling DW: Colchicine therapy for familial Mediterranean fever. A double bind trial. N Engl J Med 291:934–937, 1974

    PubMed  Google Scholar 

  17. Zemer D, Revach M, Pras M, Modan B, Schor S, Sohar E, Gafni J: A controlled trial of colchicine in preventing attacks of familial Mediterranean fever. N Engl J Med 291:932–934, 1974

    PubMed  Google Scholar 

  18. Levy M, Eliakim M: Long-term colchicine prophylaxis in familial Mediterranean fever. Br Med J 2:808, 1977

    PubMed  Google Scholar 

  19. Tripp JH, Manning JA, Muller DRP, Walker-Smith BA, Harris JT: Mucosal adenylate cyclase and sodium-potassium stimulated adenosine triphosphate in jejunal biopsies of adults and children with coeliac disease.In Perspectives in Coeliac Disease. B McNichol, CF McCarthy, PF Fottrell (eds). Lancaster, U.K., MTP Press, 1978, pp 461–470

    Google Scholar 

  20. Faloon WW, Webb DI, Race TF: Cholesterol lowering effect of colchicine. Ann Intern Med 16:1058, 1967

    Google Scholar 

  21. 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

    PubMed  Google Scholar 

  22. Faloon WW, Rublis A, Race TF, Webb DI: Colchicine and cholesterol metabolism. Am J Clin Nutr 22:671–672, 1969

    Google Scholar 

  23. Rublis A, Rubert M, Faloon WW: Cholesterol lowering, fecal bile acid, and sterol changes during neomycin and colchicine. Am J Clin Nutr 28:1251–1259, 1975

    Google Scholar 

  24. 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

    PubMed  Google Scholar 

  25. Hawkins CF, Ellis HA, Rawson A: Malignant gout with tophaceous small intestine and megaloblastic anemia. Ann Rheum Dis 24:224–233, 1965

    PubMed  Google Scholar 

  26. Rachmilewitz D, Fogel R, Karmeli F: Effect of colchicine and vinblastine on rat intestinal water transport Na-K-ATPase activity. Gut 19:759–764, 1978

    PubMed  Google Scholar 

  27. Rachmilewitz D, Karmeli F, Okon E: Effect of bisacodyl on cAMP and prostaglandin E2 contents (Na-K)ATPase, adenyl cyclase and phosphodiesterase activities of rat intestine. Dig Dis Sci 25:602–608, 1980

    PubMed  Google Scholar 

  28. Sharon P, Rachmilewitz D, Karmeli F: Effect of pentagastrin on rat jejunal fluid transport, prostaglandin E2 content, Na-K-ATPase and adenyl cyclase activities. Prostaglandins 21:81–87, 1981

    PubMed  Google Scholar 

  29. Charney AN, Donowitz M: Functional significance of intestinal Na-K-ATPase:In vivo ouabain inhibition. Am J Physiol 234:629–636, 1978

    Google Scholar 

  30. Venho VKM, Koivuniemi A: Effect of colchicine on drug absorption from the rat small intestinein situ andin vitro. Acta Pharmacol Toxicol 43:251–259, 1978

    Google Scholar 

  31. Stopa EG, O'Brien R, Katz M: Effect of colchicine on guinea pig intrinsic factor-vitamin B12 receptor. Gastroenterology 76:309–314, 1979

    PubMed  Google Scholar 

  32. Zylber-Katz E, Ehrenfeld M, Levy M, Eliakim M: Plasma colchicine concentrations in patients with recurrent polyserositis (familial Mediterranean fever) on long-term prophylaxis. Arthritis Rheum (in press)

  33. Gilat T, Revach M, Sohor E: Depositions of amyloid in the gastrointestinal tract. Gut 10:98–104, 1969

    PubMed  Google Scholar 

  34. Yoran C, Weber H, Gilat T: Studies on gastrointestinal functions in amyloidosis of familial Mediterranean fever. Scand J Gastroenterol 4:275–279, 1969

    PubMed  Google Scholar 

  35. Cohen MM, Levy M, Eliakim M: A cytogenetic evaluation of long term colchicine therapy in the treatment of familial Mediterranean fever. Am J Med Sci 274:147–152, 1977

    PubMed  Google Scholar 

  36. Levy M, Yaffe C: Testicular function in patients with familial Mediterranean fever on long-term colchicine treatment. Fertil Steril 29:667–668, 1978

    PubMed  Google Scholar 

  37. Eliakim M, Levy M, Ehrenfeld M: Recurrent Polyserositis (Familial Mediterranean Fever, Periodic Disease). Amsterdam, Elsevier/North-Holland Biomedical Press, 1981

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Hadassah University Hospital, Jerusalem, Israel

    Michael Ehrenfeld MD, Pinchas Sharon MD, Daniel Rachmilewitz MD & Marcel Eliakim MD

  2. Pharmacology Unit, Department of Medicine A, Hadassah University Hospital, 91120, Jerusalem, Israel

    Michael Ehrenfeld MD,  Micha Levy MD, Pinchas Sharon MD, Daniel Rachmilewitz MD & Marcel Eliakim MD

Authors
  1. Michael Ehrenfeld MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Micha Levy MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pinchas Sharon MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel Rachmilewitz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marcel Eliakim MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ehrenfeld, M., Levy, M., Sharon, P. et al. Gastrointestinal effects of long-term colchicine therapy in patients with recurrent polyserositis (familial Mediterranean fever). Digest Dis Sci 27, 723–727 (1982). https://doi.org/10.1007/BF01393768

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01393768

Keywords

Search

Navigation