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Review
. 2011 Apr;27(4):155-8.
doi: 10.1016/j.kjms.2010.12.010. Epub 2011 Feb 16.

Colonic necrosis in a young patient receiving oral kayexalate in sorbitol: case report and literature review

Yueh-Hung Chou  1 , Hsin-Yi Wang, Min-Shu Hsieh
Affiliations
Review

Colonic necrosis in a young patient receiving oral kayexalate in sorbitol: case report and literature review

Yueh-Hung Chou et al. Kaohsiung J Med Sci. 2011 Apr.

Abstract
in English, Chinese

Kayexalate (sodium polystyrene sulfonate) is a cation-exchange resin used to treat patients with hyperkalemia. Concomitant administration of kayexalate and sorbitol may induce gastrointestinal injury, which is potentially lethal. However, this well-documented complication is often underrecognized both clinically and pathologically. We propose a typical case along with colonoscopic photos and microscopic pictures. Additionally, we also present a review of the literature on this rare drug-induced side effect.

凱鉀力寧散 (Kayexalate; sodium polystyrene sulfonate) 是一種臨床上常用的陽離子交換樹脂，功用為降低病人的血鉀濃度。當使用山梨醣醇(sorbitol) 作為凱鉀力寧散的溶劑時，這種藥物組合可能會造成致命的腸道壞死。但是，不管是在臨床上或病理上，醫師常常忽略這個已被證實的藥物副作用。在我們提出的這個典型病例中，該病人在口服凱鉀力寧散與山梨醣醇之後，併發了典型的壞死性大腸炎；我們也附上內視鏡與病理照片，來闡述其可觀察到的變化。最後，我們也針對這個罕見但致命的藥物副作用，做詳細的文獻整理。

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Figures

Figure 1
Figure 1
The colonscopy showed multiple ulcers over splenic flexure. The endoscopic appearance of the colon ulcers included scattered erosion, longitudinal ulcerations, and sharply defined segment of involvement. The pictures were compatible with ischemic colitis.
Figure 2
Figure 2
Kayexalate crystals (A) either floating in ulcerated debris (B) or embedded in colonic lamina propria [hematoxylin and eosin; original magnification (A) 400×, (B) 200×].
Figure 3
Figure 3
Staining properties of kayexalate crystals. (A) Magenta in periodic acid‐Schiff stain (original magnification 400×). (B) Unstained in Congo red stain (original magnification 400×).
See this image and copyright information in PMC

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