01 September 2026
: Case report 
Combination of Multiple-Dose Activated Charcoal and Infusion Therapy That Led to Favorable Outcomes in Colchicine Poisoning: A Case Report
Unknown etiology, Management of emergency care
Manabu Eiraku AB 1, Kazuyuki Miyamoto E 1,2*, Keisuke Suzuki
B 1, Kazumasa Abe C 3, Tatsuro Tamatsukuri D 3, Asuka Kaizaki-Mitsumoto CDE 4, Kazuki Kikuchi B 1, Masaharu Yagi B 1, Satoshi Numazawa CD 4, Kenji Dohi DE 1
DOI: 10.12659/AJCR.953541
Am J Case Rep 2026; 27:e953541
Table 3 Intervention and monitoring timeline (h-PI = hours post ingestion).
| Event | Day, clock time | h-PI | Notes |
|---|---|---|---|
| Ingestion | Day 1, 1: 00 PM | 0 | 2 dried bulbs + energy drink (type/volume unknown) |
| Initial activated charcoal (1 g/kg) + laxative | Day 2, 4: 00 PM | 27.0 | Sodium picosulphate hydrate 75 mg; nasogastric tube |
| Infusion start (Ringer’s acetate, ~ 270 mL/h) | Day 2, 4: 00 PM | 27.0 | Subsequently titrated to 60–200 mL/h |
| Activated charcoal stool passage confirmed | Day 2, 7: 37 PM | ~32 | Also confirmed at ~ 43, ~ 55, ~ 70 h-PI |
| Dose 1 | Day 2, 4: 00 PM | 27 | Concurrent with initial AC |
| Dose 2 | Day 3, 12: 00 AM | 35 | |
| Dose 3 | Day 3, 6: 00 AM | 41 | |
| Dose 4 | Day 3, 12: 00 PM | 47 | |
| Dose 5 | Day 3, 6: 00 PM | 53 | |
| Dose 6 | Day 4, 12: 00 AM | 59 | |
| Dose 7 | Day 4, 6: 00 AM | 65 | |
| Dose 8 | Day 4, 12: 00 PM | 71 | |
| Dose 9 | Day 4, 6: 00 PM | 77 | Serum colchicine secondary rise (17.74 ng/mL) was sampled at this same time point; HDF1 had ended 2.4 h earlier (74.6 h-PI) |
| Dose 10 | Day 5, 12: 00 AM | 83 | |
| Dose 11 | Day 5, 6: 00 AM | 89 | |
| Dose 12 | Day 5, 12: 00 PM | 95 | |
| Dose 13 (final) | Day 5, 6: 00 PM | 101 | |
| HD start | Day 3, 12: 59 PM | 48.0 | Indication: toxin removal; CTA membrane 0.9 m, QB 100 / QD 500 mL/min |
| HD end | Day 3, 5: 10 PM | 52.2 | Duration 4.2 h |
| HDF1 start | Day 4, 11: 51 AM | 70.8 | PS membrane 1.5 m, QB 100 / QD 500 mL/min |
| HDF1 end | Day 4, 3: 35 PM | 74.6 | Duration 3.75 h |
| HDF2 start | Day 5, 2: 54 PM | 97.9 | PS membrane 1.5 m, QB 100 / QD 500 mL/min |
| HDF2 end | Day 5, 7: 00 PM | 102.0 | Duration 4.1 h |
| 50.3 ng/mL | Day 2, 4: 00 PM | 27.0 | On arrival; peripheral vein |
| 21.2 ng/mL | Day 3, 12: 00 AM | 35.0 | Peripheral vein |
| 12.16 ng/mL | Day 3, 12: 59 PM | 48.0 | Immediately before HD; circuit line |
| 5.46 ng/mL | Day 3, 5: 10 PM | 52.2 | Immediately after HD; circuit line |
| 3.98 ng/mL | Day 4, 6: 00 AM | 65.0 | ~ 6 h before HDF1 start; peripheral vein |
| 17.74 ng/mL | Day 4, 6: 00 PM | 77.0 | ~ 2.4 h after HDF1 end; peripheral vein Sampled at same time point as MDAC dose 9 (77 h-PI); represents secondary rise likely reflecting post-HDF1 redistribution and incomplete suppression of enterohepatic recirculation. |
| 2.54 ng/mL | Day 5, 6: 00 AM | 89.0 | ~ 9 h before HDF2 start; peripheral vein |
| 5.24 ng/mL | Day 6, 6: 00 AM | 113.0 | ~ 11 h after HDF2 end; peripheral vein |
| 110.0 ng/mL | Day 2, 6: 00 PM | 29.0 | Timed urine; first collection post-admission |
| Subsequent samples | Days 3–5 | 35–89 | Timed urine every 6 h; values shown in Figure 1 |
| Final sample | Day 6, 10: 00 AM | 117.0 | Spot urine specimen |
| Abbreviations: h-PI, hours post ingestion; AC, activated charcoal; MDAC, multiple-dose activated charcoal; HD, hemodialysis; HDF, hemodiafiltration; CTA, cellulose triacetate; PS, polysulfone; LC-MS/MS, liquid chromatography–tandem mass spectrometry; QB, blood flow rate; QD, dialysate flow rate. Day 1, date of ingestion (1: 00 PM = 0 h-PI). Serum colchicine samples without a pre/post pair immediately adjacent to HDF sessions reflect the nearest available peripheral vein specimen. | |||