Darnell Hannah, Brenner Aaron, Kern Cody, Flomenhoft Deborah, Lee Eun
Department of Internal Medicine, University of Kentucky, Lexington, KY.
Department of Digestive Diseases and Nutrition, University of Kentucky, Lexington, KY.
ACG Case Rep J. 2024 Jul 17;11(7):e01451. doi: 10.14309/crj.0000000000001451. eCollection 2024 Jul.
Sevelamer, a nonabsorbable dietary phosphate binder, is essential for patients with renal impairment since hyperphosphatemia is associated with an increase in all-cause mortality. Sevelamer is generally well tolerated; however, it is rarely been documented to cause gastrointestinal mucosal injury by forming sevelamer crystals and depositing within the gastrointestinal walls. We present a 35-year-old man with end-stage renal disease on peritoneal dialysis who developed abdominal pain and hematochezia. Initial imaging and endoscopic examination were concerning for ischemic enteritis, and histopathology revealed crystalloid structures surrounded by necrosis consistent with sevelamer-induced ischemic enteritis.
司维拉姆是一种不可吸收的膳食磷结合剂，对肾功能不全患者至关重要，因为高磷血症与全因死亡率增加有关。司维拉姆通常耐受性良好；然而，很少有文献记载它会通过形成司维拉姆晶体并沉积在胃肠道壁内而导致胃肠道黏膜损伤。我们报告一名35岁终末期肾病行腹膜透析的男性，他出现了腹痛和便血。最初的影像学和内镜检查提示为缺血性肠炎，组织病理学显示坏死周围有晶体结构，符合司维拉姆诱导的缺血性肠炎。
