BMJ  2003;327:1275-1276 (29 November), doi:10.1136/bmj.327.7426.1275

Clinical review

Lesson of the week

Colchicine in acute gout

Ian Morris, consultant rheumatologist1, George Varughese, senior house officer1, Peter Mattingly, consultant rheumatologist1

1 Department of Rheumatology, Kettering General Hospital, Kettering, Northamptonshire NN16 8UZ

Correspondence to: I Morris ian.morris@kgh.nhs.uk

The first 150 words of the full text of this article appear below.

Introduction

We describe three histories of patients with gout who were treated with doses of colchicine as advised by the British National Formulary (BNF)—that is, 1 mg initially followed by 500 µg every 2-3 hours until relief of pain is obtained or vomiting or diarrhoea occurs or until a total dose of 6 mg has been reached; the course should not be repeated within three days.1 All three patients developed nausea or diarrhoea with this regimen. We consider that an alternative low dose schedule should be used to avoid such adverse events.

Case reports

Case 1—A 91 year old woman with a history of ischaemic heart disease and non-insulin dependent diabetes developed an ulcer over the right first metatarsophalangeal joint, which was discharging a white toothpaste-like material containing urate crystals. She was given 1 mg colchicine and then 500 µg every three hours, but she developed diarrhoea, and colchicine was stopped. After . . . [Full text of this article]

Discussion


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