Calcium polystyrene sulfonate–induced colitis: advanced characterization of crystal nature with infrared spectroscopy

Author:

Vidal Helena123ORCID,Salgado Vilma34,Alves Patrícia13,Fonseca1 Nuno Moreira135,Frochot Vincent678,Ferreira Aníbal135

Affiliation:

1. Nephrology Department, Local Health Unit of Saint Joseph – Curry Cabral Hospital , Lisbon , Portugal

2. Nephrology Department, Hospital do Divino Espírito Santo de Ponta Delgada , Azores-São Miguel , Portugal

3. Lisbon Clinical Academic Center , Lisbon , Portugal

4. Pathology Department, Centro Hospitalar Universitário de Lisboa Central EPE , Lisbon , Portugal

5. Nova Medical School, Nova University of Lisbon , Lisbon , Portugal

6. Physiology Department, Hôpital Tenon, APHP , Paris , France

7. Faculty of Medicine, Pierre et Marie Curie University , Paris , France

8. INSERM UMRS 1155 , Paris , France

Abstract

ABSTRACT Classical potassium binders are used in the treatment of hyperkalemia and are widely associated with gastrointestinal side effects, with crystal colonic injury being rare but potentially fatal. In this report, we describe the case of an 82-year-old male with hyperkalemia and calcium polystyrene sulfonate crystal–associated colonic necrosis. Traditionally, this diagnosis has relied on the examination of crystal morphology and polarization through microscopy. Our study enhances crystal identification by incorporating an analysis of the physical characteristics of the crystals using infrared spectroscopy. This is the first description, to our knowledge, of the calcium polystyrene sulfonate infrared spectrum.

Publisher

Oxford University Press (OUP)

Reference6 articles.

1. Acute hyperkalemia in the emergency department;Lindner;Eur J Emerg Med,2020

2. Randomized clinical trial of sodium polystyrene sulfonate for the treatment of mild hyperkalemia in CKD;Lepage;Clin J Am Soc Nephrol,2015

3. Intestinal necrosis due to sodium polystyrene (Kayexalate) in sorbitol enemas: clinical and experimental support for the hypothesis;Lillemoe;Surgery,1987

4. Upper gastrointestinal tract injury in patients receiving kayexalate (sodium polystyrene sulfonate) in sorbitol: clinical, endoscopic, and histopathologic findings;Abraham;Am J Surg Pathol,2021

5. An unusual recurrent ileocolonic injury;Mansour;Acta Gastroenterol Belg,2021

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1. Calcium-polystyrene-sulfonate;Reactions Weekly;2024-09-07

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