Colchicine-induced vacuolar myopathy

An 83-year-old man presented to the emergency department with fatigue and proximal upper- and lower-limb weakness, 10 days after a diarrheal illness. His medical history included type 2 diabetes mellitus with polyneuropathy, chronic kidney disease (estimated glomerular filtration rate [eGFR] 34 mL/...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2025-01, Vol.197 (3), p.E69-E70
Main Authors: Pekeles, Heather, Karamchandani, Jason, Altman, Robert
Format: Article
Language:English
Subjects:
Biopsy
Blood
Causes of
Chronic kidney failure
Colchicine
Complications and side effects
Creatine kinase
Diagnosis
Dosage and administration
Electromyography
Guillain-Barre syndrome
Kidney diseases
Medical examination
Medical research
Medicine, Experimental
Muscle diseases
Practice
Type 2 diabetes
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Summary:An 83-year-old man presented to the emergency department with fatigue and proximal upper- and lower-limb weakness, 10 days after a diarrheal illness. His medical history included type 2 diabetes mellitus with polyneuropathy, chronic kidney disease (estimated glomerular filtration rate [eGFR] 34 mL/ min/1.73 m2), and gout. He had been taking colchicine 0.6 mg twice daily for the previous 9 months. He was not taking any nephrotoxic agents or statins. The patient's examination was notable for mild symmetric limb-girdle weakness, with tender ness to palpation of the quadriceps and shoulders. His creatine kinase level was 2158 U/L (36 kat/L), complete blood count was normal, and eGFR was 23 mL/min/1.73 m2. We ruled out Guillain-Barr syndrome with a nerve conduction study showing only a mild length-dependent symmetric axonal neuropathy, without any of the typical features of acquired peripheral nervous system demyelination.
ISSN:0820-3946
1488-2329
1488-2329
DOI:10.1503/cmaj.241366