Crystal associated colitis

Abstract

Cation exchange resins such as sodium polystyrene sulfonate (Kayexalate) are used to treat life threatening hyperkalaemia caused due to electrolyte imbalances. These are usually administered as an enema, orally or via nasogastric tube along with a hypertonic mixture of sorbitol to prevent constipation. Although effective, it might lead to development of rare, but serious consequences involving the gastrointestinal tract. There is a need for awareness of the rare potential adverse effects associated with its widespread use. Here, we report 2 cases of colitis induced by the administration of sodium polystyrene sulfonate which were evidenced by luminal and impacted/adherent crystals of kayexalate causing mucosal injury.