Colonic Mucosal Necrosis Following Administration of Calcium Polystryrene Sulfonate (Kalimate) in a Uremic Patient.
10.3346/jkms.2009.24.6.1207
- Author:
Mee JOO
1
;
Won Ki BAE
;
Nam Hoon KIM
;
Seong Rok HAN
Author Information
1. Department of Pathology, Inje University Ilsan Paik Hospital, Ilsan, Korea. mjoo@paik.ac.kr
- Publication Type:Case Report
- Keywords:
Polystyrene Sulfonic Acid;
Colon;
Necrosis
- MeSH:
Adult;
Colon/*pathology;
Gastrointestinal Hemorrhage/etiology;
Humans;
Hyperkalemia/drug therapy;
Intestinal Mucosa/*pathology;
Male;
Necrosis/*chemically induced/complications/pathology;
Polystyrenes/*adverse effects/therapeutic use;
Uremia/*physiopathology
- From:Journal of Korean Medical Science
2009;24(6):1207-1211
- CountryRepublic of Korea
- Language:English
-
Abstract:
Colonic necrosis is known as a rare complication following the administration of Kayexalate (sodium polystryrene sulfonate) in sorbitol. We report a rare case of colonic mucosal necrosis following Kalimate (calcium polystryrene sulfonate), an analogue of Kayexalate without sorbitol in a 34-yr-old man. He had a history of hypertension and uremia. During the management of intracranial hemorrhage, hyperkalemia developed. Kalimate was administered orally and as an enema suspended in 20% dextrose water to treat hyperkalemia. Two days after administration of Kalimate enema, he had profuse hematochezia, and a sigmoidoscopy showed diffuse colonic mucosal necrosis in the rectum and sigmoid colon. Microscopic examination of random colonic biopsies by two consecutive sigmoidoscopies revealed angulated crystals with a characteristic crystalline mosaic pattern on the ulcerated mucosa, which were consistent with Kayexalate crystals. Hematochezia subsided with conservative treatment after a discontinuance of Kalimate administration.
