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Sodium polystyrene sulfonate (Kayexalate) aspiration
Luis F Gonzalez-Cuyar1, Nathaniel B Cresswell, Allen P Burke
1Department of Pathology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland, USA. luisgonzcuyar@gmail.com
Diagnostic Pathology
|June 19, 2008
Summary
Sodium polystyrene sulfonate (SPS), used to treat hyperkalemia, can cause fatal aspiration in debilitated patients. Histological examination revealed SPS particles in the lungs, highlighting this rare iatrogenic complication.
Area of Science:
- Pathology
- Toxicology
- Internal Medicine
Background:
- Sodium polystyrene sulfonate (SPS) is a cation exchange resin used to manage hyperkalemia in patients with renal failure.
- While rectal administration with sorbitol is linked to colonic complications, oral SPS carries risks of aspiration, particularly in vulnerable individuals.
Purpose of the Study:
- To document and describe the histological findings of sodium polystyrene sulfonate aspiration.
- To raise awareness among pathologists regarding this rare iatrogenic complication.
Main Methods:
- Case report of a terminally ill patient with fatal sodium polystyrene sulfonate aspiration.
- Histological examination of lung tissue to identify aspirated material.
Main Results:
- Extensive aspiration of sodium polystyrene sulfonate was identified as the immediate cause of death.
- Histology revealed intraalveolar deposition of polygonal to amorphous basophilic crystalline particles consistent with SPS.
Conclusions:
- Oral sodium polystyrene sulfonate can lead to fatal pulmonary aspiration in debilitated patients.
- Familiarity with the histological features of SPS aspiration is crucial for accurate diagnosis of this iatrogenic event.
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