Case report: Sevelamer-associated colitis-a cause of pseudotumor formation with colon perforation and life-threatening bleeding

Margareta Fistrek Prlic; Mislav Jelakovic; Marko Brinar; Dora Grgic; Ivan Romic; Zlatko Marusic; Ema Ivandic; Bojan Jelakovic; Ivana Vukovic Brinar; Zeljko Krznaric

doi:10.3389/fmed.2023.1097469

Case report: Sevelamer-associated colitis-a cause of pseudotumor formation with colon perforation and life-threatening bleeding

Front Med (Lausanne). 2023 Apr 27:10:1097469. doi: 10.3389/fmed.2023.1097469. eCollection 2023.

Authors

Margareta Fistrek Prlic^#¹, Mislav Jelakovic^#², Marko Brinar^{2

3}, Dora Grgic², Ivan Romic⁴, Zlatko Marusic⁵, Ema Ivandic¹, Bojan Jelakovic^{1

3}, Ivana Vukovic Brinar^{1

3}, Zeljko Krznaric^{2

3}

Affiliations

¹ Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Zagreb, Croatia.
² Department of Gastroenterology, University Hospital Center Zagreb, Zagreb, Croatia.
³ School of Medicine, University of Zagreb, Zagreb, Croatia.
⁴ Department of Abdominal Surgery, University Hospital Center Zagreb, Zagreb, Croatia.
⁵ Department of Pathology, University Hospital Center Zagreb, Zagreb, Croatia.

^# Contributed equally.

Abstract

Chronic kidney disease (CKD) is a very common chronic non-communicable disease. Phosphate and calcium metabolism disorders are one of the most common features of CKD. Sevelamer carbonate is the most widely used non-calcium phosphate binder. Gastrointestinal (GI) injury associated with sevelamer use is a documented adverse effect but is underrecognized as a cause of gastrointestinal symptoms in patients with CKD. We report a case of a 74-year-old woman taking low-dose sevelamer with serious gastrointestinal adverse effects causing colon rupture and severe gastrointestinal bleeding.

Keywords: case report; chronic kidney disease; colon rupture; gastrointestinal bleeding; gastrointestinal lesion; sevelamer carbonate.

Publication types

Case Reports