Cristales de sevelamer asociados a lesión de la mucosa del tracto gastrointestinal. Presentación de 2 casos, revisión de la literatura y diagnóstico diferencial morfológico con los cristales de kayexalato

Sevelamer is a non-absorbable phosphate binder used to treat hyperphosphatemia in patients with chronic renal disease. Sevelamer morphology has been described in a recently published article by Swanson et al., in which the first histological description of this resin in the gastrointestinal tract is made. In this article we report the presence of sevelamer crystals associated with mucosal injury in 2 patients with chronic renal failure treated with this drug; one of them suffered acute perforated appendicitis with peritonitis and other developed oesophageal ulcers. We describe the histology of sevelamer crystals and the morphological differential diagnosis with kayexalate crystals, another resin used in chronic renal disease.