Colonic mucosal injury is rare, but may severely fatal, complications following the administration of
calcium polystyrene sulfonate resins. The incidence rate is about 0.57%, administered without
sorbitol, and increases to 1.8% when it is concomitant with
sorbitol, especially in postoperative patients. In this case report, we demonstrated the case of a 77-year-old female with stage 3b
chronic kidney disease presented with in-hospital
hematochezia after 3 weeks of
calcium polystyrene sulfonate administration. The colonoscopic findings showed several serpiginous
ulcers with some oozing at descending and sigmoid colon. The histological findings revealed some focal
inflammation and ulcerations with crystal-like materials, compatible with
cation exchange resins. The recent in vitro study, explaining the pathogenesis of
cation exchange resin-associated colonic mucosal injury, was also reviewed.