Treatment of Pediatric Colchicine Poisoning with Single-Pass Albumin Dialysis: A Case Report
Bibliographic record
Abstract
Introduction: Colchicine has a narrow therapeutic index, and doses >0.5 mg/kg are considered toxic with a high mortality rate. Case Presentation: A previously healthy 15-year-old presents to the emergency department with abdominal pain and vomiting following intentional ingestion of colchicine (0.56 mg/kg) 12 h prior. By 24 h post-ingestion, they developed a multi-organ injury with hepatic dysfunction, coagulopathy, lactic acidemia, and pancytopenia, which prompted consideration of extracorporeal therapy (ECT). Considering the characteristics of colchicine, they were treated with continuous venovenous hemodiafiltration (CVVHDF) with single-pass albumin dialysis (SPAD) for 42 h. They were subsequently discharged from the intensive care unit 48 h after stopping CVVHDF with normal kidney function, resolved coagulopathy, and resolving pancytopenia and hepatic dysfunction. The rationale for CVVHDF with SPAD was based on the high protein binding, variably high volume of distribution, previous reports showing a sieving coefficient of 0.2 with CVVH, and the high mortality risk. We anticipated a high potential for rebound. Thus, continuous clearance would facilitate redistribution from the extravascular to intravascular space. SPAD was used to enhance the elimination of protein-bound fractions; the principle is that adding albumin to dialysate creates a protein-binding disequilibrium where the drug from the blood side may bind to albumin on the dialysate side. Conclusion: Colchicine ingestion of >0.5 mg/kg is highly toxic, and in addition to supportive management, continuous kidney replacement therapy with SPAD may be considered.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".