A case report of sevelamer-associated recto-sigmoid ulcers

Christina Tieu, Roger K. Moreira, Louis M Wong Kee Song, Shounak Majumder, Konstantinos Papadakis, Marie C Hogan

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Optimal phosphorous control is an important aspect of the care of patients with end-stage renal disease, and phosphate binders are usually needed. Case presentation: A 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. Conclusion: Sevelamer 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.

Original languageEnglish (US)
Article number20
JournalBMC Gastroenterology
Volume16
Issue number1
DOIs
StatePublished - Feb 24 2016

Fingerprint

Sigmoid Colon
Ulcer
Phosphates
Chronic Kidney Failure
Hyperphosphatemia
Gastroenterology
Bile Acids and Salts
Chronic Renal Insufficiency
Abdomen
Amines
Renal Dialysis
Hospital Emergency Service
Patient Care
Tomography
Maintenance
Carcinoma
Kidney
Pain
Sevelamer

Keywords

  • End-stage renal disease
  • Hyperphosphatemia
  • Phosphate binder
  • Recto-sigmoid ulcers
  • Rectosigmoiditis
  • Sevelamer

ASJC Scopus subject areas

  • Gastroenterology

Cite this

A case report of sevelamer-associated recto-sigmoid ulcers. / Tieu, Christina; Moreira, Roger K.; Song, Louis M Wong Kee; Majumder, Shounak; Papadakis, Konstantinos; Hogan, Marie C.

In: BMC Gastroenterology, Vol. 16, No. 1, 20, 24.02.2016.

Research output: Contribution to journalArticle

Tieu, Christina ; Moreira, Roger K. ; Song, Louis M Wong Kee ; Majumder, Shounak ; Papadakis, Konstantinos ; Hogan, Marie C. / A case report of sevelamer-associated recto-sigmoid ulcers. In: BMC Gastroenterology. 2016 ; Vol. 16, No. 1.
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