Esophagus
Other nonneoplastic
Kayexalate damage
Author: Elliot Weisenberg, M.D.
Topic Completed: 1 December 2012
Minor changes: 11 May 2021
Copyright: 2003-2021, PathologyOutlines.com, Inc.
PubMed Search: Kayexalate damage
Table of Contents
Definition / general | Case reports | Microscopic (histologic) description | Microscopic (histologic) images | Board review style question #1 | Board review style answer #1Cite this page: Weisenberg E. Kayexalate damage. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/esophaguskayexalate.html. Accessed October 22nd, 2021.
Definition / general
- Kayexalate (sodium polystyrene sulfonate) in sorbitol is used to treat hyperkalemia
- Symptoms are from sorbitol, given orally though NG tube or as an enema, may crystallize in esophagus, stomach or duodenum and produce endoscopic ulcers and erosions resembling carcinoma or Candida (Am J Surg Pathol 2001;25:637)
- Colonic infarction and erosions reported
Case reports
- 65 year old man with history of esophageal cancer and end stage renal disease (Case of the Week #460)
Microscopic (histologic) description
- Crystals are lightly basophilic with a faint crystalline mosaic pattern, better seen with PAS / Alcian blue
- Crystals are refractile but not polarizable, luminal and adherent to intact surface epithelium or mixed with inflammatory exudate in patients with ulcer or erosion
Microscopic (histologic) images
Contributed by Dr. Ankur Sangoi
Various images
AFB stain
Board review style question #1
Which of the following microscopically identifiable medication materials typically shows a two tone appearance with a fish scale pattern on H&E?
A. Cholestyramine
B. Crospovidone
C. Sevelamer
D. Sodium polystyrene sulfonate
A. Cholestyramine
B. Crospovidone
C. Sevelamer
D. Sodium polystyrene sulfonate
Board review style answer #1
