COLCHICINE-INDUCED LACTOSE-MALABSORPTION IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER

Abdominal pain and diarrhea are frequent side effects of chronic colch icine therapy. Drug-induced lactose deficiency has been demonstrated i n the experimental animal. Lactose malabsorption was assessed by the l actose breath test in 23 patients with familial Mediterranean fever (F MF) receiving colchicine for 0.25-15 years (mean 3.16). Twenty FMF pat ients not receiving colchicine and 38 non-FMF lactose malabsorbers ser ved as controls. Patients receiving colchicine had a significantly hig her percentage of lactose malabsorption (20/23, 87%) versus nontreated FMF patients (13/20, 65%; P <0.05). Lactose intolerance was also more prevalent in colchicine-treated patients (17/23, 74%) versus nontreat ed FMF (5/20, 25%; P <0.0005) and control lactose malabsorbers (16/38, 42%; P <0.01). Of the 12 patients investigated before and 3 months af ter colchicine administration, 7 showed induction or aggravation of la ctose malabsorption. The lactose-free diet resulted in partial improve ment of symptoms. Colchicine induces significant lactose malabsorption in FMF patients and this is partially responsible for the gastrointes tinal side effects of the drug.