COLCHICINE±INDUCED MYOPATHY. K. Gupta 1 , T.A. Townley 1 ; 1 Creighton University, Omaha, NE (Tracking ID #76577) LEARNING OBJECTIVES: 1) Review the differential diagnosis of proximal muscle weakness in an elderly male 2) Review symptoms and signs of colchicine-myopathy 3) Review the risks factors for colchicine myopathy. CASE INFORMATION: INTRODUCTION: Colchicine has been used for 200 + years, but there are few reports of myopathy associated with its use. We present such a case. CASE: Patient is a 70-year-old male who was hospitalized for abdominal pain/diarrhea. He had fallen on his hip at home 1 week prior to his admission and became increasingly weak with considerable reductions in his ADL such as inability to get in and out of bed, stand from sitting and walk. His PMH includes COPD on home O2, CHF, HTN, DM, CRI (baseline Cr 2.2), obesity and gout. Medications include Oxycodone 5/325mg prn, metoprolol 50mg qd, colchicine 0.6mg qd, allopurinol 100mg qd, furosemide 80mg qd, glipizide 30mg qd, isosorbide dinitrate 30mg qd, fosinopril 40mg qd, ASA 325mg qd, KCl 20mEq qd, Insulin 70/30, MVI qd. His initial physical exam was normal except for reduced reflexes in upper limbs 2+/4 and lower limbs 1+/4 with no sensory deficits. Lab work revealed acute renal insufficiency on CRI (BUN 69/Cr 2.6), in addition LFT's were twice normal. CK was 1059 with MB fraction <5%. CXR and abdominal series were clear and EKG was unchanged. His abdominal pain resolved, and ARI improved with hydration and discontinuation of ACE-I. Initially his weakness was felt to be secondary to intercurrent illness superimposed on chronic illness. However weakness failed to improve and a repeat CK was 1825 with ESR of 36. His weakness localized to proximal muscles of upper and lower extremities, with strength 3/5. Distal muscle strength was 5/5. Colchicine was suspected as the cause of his myopathy and discontinued. He noticed a significant improvement in his proximal muscle of 4/5 on the following day. EMG showed myositis with predominantly proximal muscle irritability. Repeat labs 5 days after discontinuing colchicine, showed BUN 44/ Cr 1.4, and CK 958. There was a noticeable improvement in strength, with ability to stand from sitting, ambulate across room and get into and out of bed alone. IMPLICATIONS/DISCUSSION: DISCUSSION: Patients taking colchicine over an extended period of time have been reported to develop a subacute, often severe myopathy in conjunction with a relatively mild polyneuropathy. Chronic renal failure is a risk factor for this syndrome. Our patient had been on colchicine for more than a year. In this case an untreated myopathy may have resulted in nursing home placement versus a trial of steroids for polymyositis. In our patient, who had pre-existing renal insufficiency worsened by the dehydration, the clinical presentation and the improvement on discontinuation of colchicine strongly supports the diagnosis of Colchicine induced myopathy.