Sevelamer Induced Colitis Causing Deep Cratered Ulcer in an End-Stage Renal Disease Patient

Shawn Philip^1, , Muhammad Farhan Ashraf¹, Mary Strader², Hala Abdelwahab³ and Asra Batool²

¹Albany Medical Center, Department of Internal Medicine, Albany, NY. USA

²Albany Medical Center, Department of Gastroenterology, Albany, NY. USA

³Albany Medical Center, Department of Pathology, Albany, NY. USA

Cite this paper

Shawn Philip, Muhammad Farhan Ashraf, Mary Strader, Hala Abdelwahab and Asra Batool. Sevelamer Induced Colitis Causing Deep Cratered Ulcer in an End-Stage Renal Disease Patient. American Journal of Medical Case Reports. 2022; 10(6):173-175. doi: 10.12691/AJMCR-10-6-3

Abstract

Sevelamer is phosphate lowering oral agent used in chronic kidney disease (CKD) to decrease oral phosphate absorption. Sevelamer has been shown to cause crystalline induced colitis. This can manifest as abdominal pain or gastrointestinal bleeding. We present a case with chronic kidney disease and Moyamoya syndrome that presented with abdominal pain and anemia. Colonoscopy revealed a single circumferential cratered ulcer in the transverse colon. Pathology showed crystalline induced colitis. Sevelamer was discontinued and the patient`s symptoms improved.

Keywords

Sevelamer, colitis, ulcer

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Floege J. Phosphate binders in chronic kidney disease: a systematic review of recent data. Journal of nephrology. 2016; 29(3): 329-340.
[2]	Abbasian N, Burton JO, Herbert KE, et al. Hyperphosphatemia, phosphoprotein phosphatases, and microparticle release in vascular endothelial cells. Journal of the american society of nephrology. 2015; 26(9): 2152-2162.
[3]	Cozzolino M, Rizzo MA, Gallieni M, et al. Sevelamer for hyperphosphataemia in kidney failure: Controversy and perspective. Therapeutic advances in chronic disease. 2012; 3(2): 59-68.
[4]	Swanson BJ, Limketkai BN, Liu TC, et al. Sevelamer crystals in the gastrointestinal tract (GIT): A new entity associated with mucosal injury. American journal of surgical pathology. 2013; 37(11): 1686-1693.
[5]	Yuste C, Mérida E, Hernandez E, et al. Gastrointestinal complications induced by sevelamer crystals. Clinical kidney journal. 2017; 10(4): 539-544.
[6]	Okwara C, Choi C, Park JY. Sevelamer-Induced Colitis Presenting as a Pseudotumor. YJCGH. 2015; 13: A39-A40.
[7]	Hung OY, Maithel SK, Willingham FF, Farris AB, Kauh JS. Hypergastrinemia, type 1 gastric carcinoid tumors: Diagnosis and management. J Clin Oncol. 2011; 29(25): e713-e715.
[8]	Madan P, Bhayana S, Chandra P, et al. Lower gastrointestinal bleeding: Association with Sevelamer use. World journal of gastroenterology.2008; 14(16): 2615-2616.
[9]	Lai T, Frugoli A, Barrows B, et al. Sevelamer Carbonate Crystal-Induced Colitis. Case reports in gastrointestinal medicine. 2020; 2020: 1-4.
[10]	Uy PP, Vinsard DG, Hafeez S. Sevelamer-Associated Rectosigmoid Ulcers in an End-Stage Renal Disease Patient. ACG case reports journal. 2018; 5(11): e831-3.