Crystal-Associated Colitis with Ulceration Leading to Hematochezia and Abdominal Pain
Lower GI bleeding is a common cause for hospitalization in adults. Medication-associated mucosal injury is an important clinical entity that can result in significant morbidity and mortality. We present the case of a 45-year-old woman with a 3-month history of intermittent abdominal cramping and rec...
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| Published in: | Case reports in gastroenterology Vol. 10; no. 2; pp. 332 - 337 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
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Basel, Switzerland
S. Karger AG
23-06-2016
Karger Publishers |
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| Abstract | Lower GI bleeding is a common cause for hospitalization in adults. Medication-associated mucosal injury is an important clinical entity that can result in significant morbidity and mortality. We present the case of a 45-year-old woman with a 3-month history of intermittent abdominal cramping and rectal bleeding. Her medical history was extensive and included end-stage renal disease and a remote history of endometrial carcinoma that was treated with radiation. Initial workup was concerning for ischemic and radiation colitis, however, histology was most consistent with acute inflammation and ulceration associated with crystal fragments. Sevelamer and cholestyramine are commonly used ion-exchange resins that have been associated with mucosal damage. Both medications were discontinued and her symptoms resolved. Our case highlights an underrecognized but important cause of hematochezia. |
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| AbstractList | Lower GI bleeding is a common cause for hospitalization in adults. Medication-associated mucosal injury is an important clinical entity that can result in significant morbidity and mortality. We present the case of a 45-year-old woman with a 3-month history of intermittent abdominal cramping and rectal bleeding. Her medical history was extensive and included end-stage renal disease and a remote history of endometrial carcinoma that was treated with radiation. Initial workup was concerning for ischemic and radiation colitis, however, histology was most consistent with acute inflammation and ulceration associated with crystal fragments. Sevelamer and cholestyramine are commonly used ion-exchange resins that have been associated with mucosal damage. Both medications were discontinued and her symptoms resolved. Our case highlights an underrecognized but important cause of hematochezia. |
| Author | Reiprich, Aaron Khov, Nancy Levenick, John Mathew, Abraham Yang, Zhaohai Desai, Meeta |
| AuthorAffiliation | a Department of Internal Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pa., USA d Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, Pa., USA b Department of Internal Medicine, Pinnacle Health, Harrisburg, Pa., USA c Department of Gastroenterology and Hepatology, Penn State Milton S. Hershey Medical Center, Hershey, Pa., USA |
| AuthorAffiliation_xml | – name: d Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, Pa., USA – name: a Department of Internal Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pa., USA – name: b Department of Internal Medicine, Pinnacle Health, Harrisburg, Pa., USA – name: c Department of Gastroenterology and Hepatology, Penn State Milton S. Hershey Medical Center, Hershey, Pa., USA |
| Author_xml | – sequence: 1 givenname: Meeta surname: Desai fullname: Desai, Meeta email: mdesai@hmc.psu.edu – sequence: 2 givenname: Aaron surname: Reiprich fullname: Reiprich, Aaron – sequence: 3 givenname: Nancy surname: Khov fullname: Khov, Nancy – sequence: 4 givenname: Zhaohai surname: Yang fullname: Yang, Zhaohai – sequence: 5 givenname: Abraham surname: Mathew fullname: Mathew, Abraham – sequence: 6 givenname: John surname: Levenick fullname: Levenick, John |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27482192$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1097/PAS.0b013e3182999d8d 10.1007/s11894-010-0146-8 10.1016/j.cgh.2008.03.021 10.1007/s11894-013-0333-5 10.1111/sdi.12301 10.5858/arpa.2012-0205-RA 10.1016/j.humpath.2007.01.014 10.1097/PAS.0000000000000260 10.1016/j.surg.2009.06.055 |
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| Keywords | Crystal deposition Sevelamer Cholestyramine Ulceration Hematochezia |
| Language | English |
| License | This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
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| Title | Crystal-Associated Colitis with Ulceration Leading to Hematochezia and Abdominal Pain |
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