1.Colonic Mucosal Necrosis Following Administration of Calcium Polystryrene Sulfonate (Kalimate) in a Uremic Patient.
Mee JOO ; Won Ki BAE ; Nam Hoon KIM ; Seong Rok HAN
Journal of Korean Medical Science 2009;24(6):1207-1211
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.
Adult
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Colon/*pathology
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Gastrointestinal Hemorrhage/etiology
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Humans
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Hyperkalemia/drug therapy
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Intestinal Mucosa/*pathology
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Male
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Necrosis/*chemically induced/complications/pathology
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Polystyrenes/*adverse effects/therapeutic use
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Uremia/*physiopathology