Uy Pearl Princess, Vinsard Daniela Guerrero, Hafeez Safina
Department of Internal Medicine, University of Connecticut Health Center, Hartford, CT.
Department of Pathology, Hartford Hospital, Hartford, CT.
ACG Case Rep J. 2018 Nov 28;5:e83. doi: 10.14309/crj.2018.83. eCollection 2018.
Sevelamer carbonate is a commonly prescribed anion-exchange resin administered orally to prevent hyperphosphatemia in patients with chronic kidney disease. We present a rare case of a 33-year-old man with end-stage renal disease and diabetic gastroparesis on sevelamer carbonate, who presented with hematochezia and was found to have rectosigmoid ulcers induced by sevelamer crystals. His hematochezia resolved after switching from sevelamer carbonate to lanthanum carbonate. Clinicians and pathologists must be aware of the possibility of drug-induced mucosal ulceration associated with sevelamer use as a potential etiology of a gastrointestinal bleed.
碳酸司维拉姆是一种常用的阴离子交换树脂，口服给药用于预防慢性肾脏病患者的高磷血症。我们报告一例罕见病例，一名33岁患有终末期肾病和糖尿病胃轻瘫的男性正在服用碳酸司维拉姆，他出现了便血，经检查发现是由司维拉姆结晶诱发的直肠乙状结肠溃疡。将碳酸司维拉姆换成碳酸镧后，他的便血症状得到缓解。临床医生和病理学家必须意识到，使用司维拉姆可能会导致药物性黏膜溃疡，这是胃肠道出血的一个潜在病因。
