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Peer-reviewedCC BYCureus

Kayexalate-Induced Ischemic Colitis: Revisiting a Forgotten but Preventable Cause of Colonic Necrosis.

  • Chorouq Mehdaoui1
  • Chaimae Daoudi2
  • Anass Haloui2
  • Amal Bennani3
  • Hajar Koulali1
  • Ouiam Elmqaddam1
  • Abdelkrim Zazour4
  • Zahi Ismaili4
  • Ghizlane Kharrasse4
4 affiliations
  1. 1Department of Hepato-Gastroenterology, Mohammed VI University Hospital Center/Mohammed First University, Oujda, MAR.
  2. 2Department of Pathology, Mohammed VI University Hospital Center/Mohammed First University, Oujda, MAR.
  3. 3Department of Pathology, Mohammed VI University Hospital Center/LAPOD (Research Laboratory of Pathology and Digestive Oncology), Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR.
  4. 4Department of Hepato-Gastroenterology, Mohammed VI University Hospital Center/LAPOD (Research Laboratory of Pathology and Digestive Oncology), Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR.
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Abstract

Sodium polystyrene sulfonate (SPS), commonly used to treat hyperkalemia, has rarely been associated with severe gastrointestinal injury. We describe a 72-year-old man with chronic kidney disease on long-term SPS therapy who presented with melena and acute kidney injury requiring hemodialysis. Colonoscopy revealed a large ulcerated lesion in the sigmoid colon. Abdominal CT angiography revealed circumferential sigmoid wall thickening with patent mesenteric arteries, raising suspicion of ischemic colitis. Histological examination showed mucosal ulceration and characteristic basophilic, angulated crystals exhibiting a mosaic-like "fish-scale" pattern on hematoxylin and eosin staining, consistent with SPS deposition and supporting the diagnosis of SPS-induced ischemic colitis. SPS was discontinued, and the patient improved with supportive treatment alone. Awareness of this rare complication is important, as early recognition and drug withdrawal may prevent intestinal necrosis, perforation, and death.

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Cite

BibTeXRIS
BibTeX
@article{mehdaoui2026kayexalateinduced,
  title = {{Kayexalate-Induced Ischemic Colitis: Revisiting a Forgotten but Preventable Cause of Colonic Necrosis.}},
  author = {Chorouq Mehdaoui and Chaimae Daoudi and Anass Haloui and Amal Bennani and Hajar Koulali and Ouiam Elmqaddam and Abdelkrim Zazour and Zahi Ismaili and Ghizlane Kharrasse},
  journal = {Cureus},
  year = {2026},
  month = oct,
  doi = {10.7759/cureus.118023},
  url = {https://europepmc.org/article/MED/42927149},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Kayexalate-Induced Ischemic Colitis: Revisiting a Forgotten but Preventable Cause of Colonic Necrosis.
AU  - Chorouq Mehdaoui
AU  - Chaimae Daoudi
AU  - Anass Haloui
AU  - Amal Bennani
AU  - Hajar Koulali
AU  - Ouiam Elmqaddam
AU  - Abdelkrim Zazour
AU  - Zahi Ismaili
AU  - Ghizlane Kharrasse
PY  - 2026
DA  - 2026/10/16
JO  - Cureus
DO  - 10.7759/cureus.118023
UR  - https://europepmc.org/article/MED/42927149
AB  - Sodium polystyrene sulfonate (SPS), commonly used to treat hyperkalemia, has rarely been associated with severe gastrointestinal injury. We describe a 72-year-old man with chronic kidney disease on long-term SPS therapy who presented with melena and acute kidney injury requiring hemodialysis. Colonoscopy revealed a large ulcerated lesion in the sigmoid colon. Abdominal CT angiography revealed circumferential sigmoid wall thickening with patent mesenteric arteries, raising suspicion of ischemic colitis. Histological examination showed mucosal ulceration and characteristic basophilic, angulated crystals exhibiting a mosaic-like "fish-scale" pattern on hematoxylin and eosin staining, consistent with SPS deposition and supporting the diagnosis of SPS-induced ischemic colitis. SPS was discontinued, and the patient improved with supportive treatment alone. Awareness of this rare complication is important, as early recognition and drug withdrawal may prevent intestinal necrosis, perforation, and death.
SN  - 2168-8184
ER  -