A case report of sevelamer-associated recto-sigmoid ulcers

BMC Gastroenterology

Case Report

Roger K. Moreira¹  Christina Tieu²  Konstantinos A. Papadakis³  Louis M. Wong Kee Song³  Shounak Majumder³  Marie C. Hogan⁴ 

[1] Department of Anatomic Pathology, Mayo Clinic, 55905, Rochester, MN, USA;Department of Internal Medicine, Mayo Clinic, 55905, Rochester, MN, USA;Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, 55905, Rochester, MN, USA;Division of Nephrology & Hypertension, Department of Medicine, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA;

关键词: End-stage renal disease;    Hyperphosphatemia;    Phosphate binder;    Recto-sigmoid ulcers;    Rectosigmoiditis;    Sevelamer;   

DOI  :  10.1186/s12876-016-0441-4

 received in 2015-09-04, accepted in 2016-02-18,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundOptimal phosphorous control is an important aspect of the care of patients with end-stage renal disease, and phosphate binders are usually needed.Case presentationA 74-year-old woman with end-stage renal disease on maintenance hemodialysis presented to the emergency room with abdominal discomfort, rectal pain, and blood-tinged stools. Initial concern was for a rectal carcinoma, based on the symptoms and imaging in initial computerized tomography of the abdomen showing rectal wall thickening, and her clinical presentation. She had been treated with the phosphate binder sevelamer for two months. In this case report, we explore the unique features of sevelamer-associated recto-sigmoid ulcers which led to her symptoms.ConclusionSevelamer is widely used in chronic kidney disease and end-stage renal disease patients with hyperphosphatemia. It is a crosslinked polymeric amine that binds phosphates and bile acids; it is not systemically absorbed. To the authors’ knowledge, this is the first reported case of recto-sigmoid ulcers associated with use of this phosphate binder. Nephrologists, pathologists, and gastroenterology sub-specialists should be aware of this recently-reported entity in patients on sevelamer with suggestive symptoms, as this medication is widely used in renal patients.

【 授权许可】

CC BY   
© Tieu et al. 2016