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Abstract An 82 year-old woman with gouty arthritis developed acute diarrhea, vomiting, myalgia and generalized muscle weakness after she had mistakenly increased the dose of colchicine (0.6 mg/tablet) from once a day to three times/day for 1 week. She was found to have pancytopenia, proximal muscle weakness and elevated serum muscle enzymes. A clinical diagnosis of colchicine myotoxicity and hematotoxicity was made. Despite aggressive therapy, she died on the 5th hospital day. This patient represented another case of the rare side effect of colchicine, and the risk factors involved in the occurrence of colchicine toxicity is reviewed. Chiang Mai Med Bull 2004;43(2):87-92