Department of Pathology, Inje University Ilsan Paik Hospital, Ilsan, Korea.
J Korean Med Sci. 2009 Dec;24(6):1207-11. doi: 10.3346/jkms.2009.24.6.1207. Epub 2009 Nov 9.
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.
结肠坏死是服用 Kayexalate（聚苯乙烯磺酸钙）和山梨醇后罕见的并发症。我们报告一例 34 岁男性服用 Kalimate（聚苯乙烯磺酸钙）后发生结肠黏膜坏死的罕见病例，这是一种类似于 Kayexalate 的药物，但不含山梨醇。该患者有高血压和尿毒症病史。在治疗颅内出血期间，发生了高钾血症。给予患者口服和用 20%葡萄糖水混悬的灌肠剂来治疗高钾血症。在给予 Kalimate 灌肠后的第 2 天，他出现大量血便，乙状结肠镜检查显示直肠和乙状结肠弥漫性结肠黏膜坏死。两次乙状结肠镜检查随机活检的显微镜检查显示在溃疡性黏膜上有角状晶体，具有特征性的结晶镶嵌模式，这与 Kayexalate 晶体一致。停用 Kalimate 后，保守治疗后血便消退。
