The Successful Treatment of Sodium Polystyrene Sulfonate-induced Enteritis Diagnosed by Small Bowel Endoscopy

Intern Med. 2018 Jun 1;57(11):1577-1581. doi: 10.2169/internalmedicine.0088-17. Epub 2018 Jan 11.

Abstract

Sodium polystyrene sulfonate (SPS: Kayexalate®) is an ion-exchange resin used to treat hyperkalemia in patients with chronic kidney disease. It is known that this resin sometimes causes colonic necrosis and perforation, but there are few reports about small bowel necrosis associated with SPS. We herein report the case of a patient who developed SPS-induced small bowel necrosis, which was diagnosed based on the examination of a small bowel endoscopic biopsy specimen. The SPS-induced small bowel necrosis was resistant to conservative treatment including the cessation of SPS, and finally required surgical bowel resection.

Keywords: chronic kidney disease; small bowel necrosis; sodium polystyrene sulfonate.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cation Exchange Resins / adverse effects*
  • Endoscopy, Gastrointestinal
  • Enteritis / chemically induced
  • Enteritis / diagnostic imaging
  • Enteritis / pathology
  • Enteritis / surgery*
  • Humans
  • Hyperkalemia / drug therapy
  • Hyperkalemia / etiology
  • Intestine, Small / diagnostic imaging
  • Intestine, Small / pathology*
  • Intestine, Small / surgery
  • Laparoscopy
  • Male
  • Necrosis / chemically induced
  • Polystyrenes / adverse effects*
  • Renal Insufficiency, Chronic / complications
  • Tomography, X-Ray Computed

Substances

  • Cation Exchange Resins
  • Polystyrenes
  • polystyrene sulfonic acid