title: Colonic mucosal necrosis following administration of calcium polystryrene sulfonate (Kalimate) in a uremic patient.
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.
authors: Department of Pathology, Inje University Ilsan Paik Hospital, Ilsan, Korea. mjoo@paik.ac.kr
authors: Mee
authors: M
authors: Joo
authors: Won Ki
authors: WK
authors: Bae
authors: Nam Hoon
authors: NH
authors: Kim
authors: Seong Rok
authors: SR
authors: Han
mesh_terms: D000328:Adult; D003106:Colon / Q000473:pathology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006947:Hyperkalemia / Q000188:drug therapy; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D009336:Necrosis / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D011137:Polystyrenes / Q000009:adverse effects* / Q000627:therapeutic use; D014511:Uremia / Q000503:physiopathology*
chemical_list: D011137:Polystyrenes; C003321:polystyrene sulfonic acid