Upper Gastrointestinal Bleeding Secondary to Sodium Polystyrene Sulfonate Use: A Rare Adverse Effect of Commonly Prescribed Treatment

Author:

Shariff Hamzah1ORCID,Naidoo Shiva2,Ghafari Ghazal3,Li Hongjie3,Devi Manisha4,Kumar Kishore5

Affiliation:

1. Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA

2. Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, Pennsylvania, USA

3. Department of Clinical and Laboratory Pathology, Geisinger Medical Center, Danville, Pennsylvania, USA

4. Department of Internal Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA

5. Department of Gastroenterology, Geisinger Community Medical Center, Scranton, Pennsylvania, USA

Abstract

We report a case of a 62-year-old man who was brought in by emergency medical services after a fall and change in mental status. He was found to have severe hyperkalemia, acute kidney injury, and rhabdomyolysis. The hyperkalemia was treated with sodium polystyrene sulfonate (SPS). During hospitalization, he witnessed having black tarry stools along with a significant drop in hemoglobin. Endoscopic evaluation demonstrated nonbleeding large diffuse gastric ulcers with stigmata of recent bleeding, and ulcer biopsy revealed findings consistent with SPS-induced gastric ulceration. No other source of bleeding was localized, suggesting acute upper gastrointestinal bleeding due to SPS mucosal injury.

Publisher

Hindawi Limited

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