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A case report of sevelamer-associated recto-sigmoid ulcers
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 abdomina...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765035/ https://www.ncbi.nlm.nih.gov/pubmed/26911806 http://dx.doi.org/10.1186/s12876-016-0441-4 |
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author | Tieu, Christina Moreira, Roger K. Song, Louis M. Wong Kee Majumder, Shounak Papadakis, Konstantinos A. Hogan, Marie C. |
author_facet | Tieu, Christina Moreira, Roger K. Song, Louis M. Wong Kee Majumder, Shounak Papadakis, Konstantinos A. Hogan, Marie C. |
author_sort | Tieu, Christina |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4765035 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47650352016-02-25 A case report of sevelamer-associated recto-sigmoid ulcers Tieu, Christina Moreira, Roger K. Song, Louis M. Wong Kee Majumder, Shounak Papadakis, Konstantinos A. Hogan, Marie C. BMC Gastroenterol Case Report 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. BioMed Central 2016-02-24 /pmc/articles/PMC4765035/ /pubmed/26911806 http://dx.doi.org/10.1186/s12876-016-0441-4 Text en © Tieu et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Tieu, Christina Moreira, Roger K. Song, Louis M. Wong Kee Majumder, Shounak Papadakis, Konstantinos A. Hogan, Marie C. A case report of sevelamer-associated recto-sigmoid ulcers |
title | A case report of sevelamer-associated recto-sigmoid ulcers |
title_full | A case report of sevelamer-associated recto-sigmoid ulcers |
title_fullStr | A case report of sevelamer-associated recto-sigmoid ulcers |
title_full_unstemmed | A case report of sevelamer-associated recto-sigmoid ulcers |
title_short | A case report of sevelamer-associated recto-sigmoid ulcers |
title_sort | case report of sevelamer-associated recto-sigmoid ulcers |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765035/ https://www.ncbi.nlm.nih.gov/pubmed/26911806 http://dx.doi.org/10.1186/s12876-016-0441-4 |
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