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

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.

摘要凱鉀力寧散 (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。