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Rectal ulcer due to Kayexalate deposition - an unusual case.
Oliveira, Ana Alves; Pedro, Filipa; Craveiro, Nuno; Cruz, Ana Vera; Almeida, Raquel Sousa; Luís, Pedro Pereira; Santos, Cristina.
Afiliação
  • Oliveira AA; . Internal Medicine Department, Medicine Service III - Santarém Hospital - Santarém, Santarém, Portugal.
  • Pedro F; . Internal Medicine Department, Medicine Service III - Santarém Hospital - Santarém, Santarém, Portugal.
  • Craveiro N; . Internal Medicine Department, Medicine Service III - Santarém Hospital - Santarém, Santarém, Portugal.
  • Cruz AV; . Internal Medicine Department, Medicine Service III - Santarém Hospital - Santarém, Santarém, Portugal.
  • Almeida RS; . Internal Medicine Department, Medicine Service III - Santarém Hospital - Santarém, Santarém, Portugal.
  • Luís PP; . Pathological Anatomy Service - Santarém Hospital - Santarém, Santarém, Portugal.
  • Santos C; . Internal Medicine Department, Medicine Service III - Santarém Hospital - Santarém, Santarém, Portugal.
Rev Assoc Med Bras (1992) ; 64(8): 680-683, 2018 Aug.
Article em En | MEDLINE | ID: mdl-30673037
Sodium polystyrene sulfonate (PSP) or Kayexalate is a cation-exchange resin, widely used in the management of hyperkalaemia due to renal disease. A rare, yet potentially dangerous, adverse event related to sodium polystyrene sulfonate use is intestinal mucosal injury, especially in the colon. The injury to the gastrointestinal mucosa can range from mild and superficial to wall necrosis and bowel perforation. The mechanism that leads to mucosal damage remains unclear. However, it is believed that sorbitol, commonly given to counteract PSP's tendency to cause constipation, may play an important role in the development of gastrointestinal injury. Other potential risk factors are uraemia or end-stage renal disease, hemodynamic instability, solid organ transplantation, postoperative status and concomitant opioid administration. The authors present a case of diarrhoea and haematochezia after the administration of PSP without sorbitol, in a patient with hyperkalaemia due to acute kidney injury, in the absence of other risk factors. A colonoscopy was performed and revealed a rectal ulcer which histological findings were suggestive of mucosal injury due to Kayexalate deposition. This case supports the concept that this widely used drug can itself, without sorbitol, cause injury to the gastrointestinal wall. Even though this is a rare adverse effect, the widespread use of this medication may put a large population at risk.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Poliestirenos / Doenças Retais / Úlcera / Resinas de Troca de Cátion Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Aged80 / Female / Humans Idioma: En Revista: Rev Assoc Med Bras (1992) Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Portugal País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Poliestirenos / Doenças Retais / Úlcera / Resinas de Troca de Cátion Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Aged80 / Female / Humans Idioma: En Revista: Rev Assoc Med Bras (1992) Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Portugal País de publicação: Brasil