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首页> 外文期刊>Journal of perinatology: Official journal of the California Perinatal Association >Necrotizing enterocolitis in a 850 gram infant receiving sorbitol-free sodium polystyrene sulfonate (Kayexalate): clinical and histopathologic findings.
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Necrotizing enterocolitis in a 850 gram infant receiving sorbitol-free sodium polystyrene sulfonate (Kayexalate): clinical and histopathologic findings.

机译：接受无山梨醇的聚苯乙烯磺酸钠（Kayexalate）的850克婴儿的坏死性小肠结肠炎：临床和组织病理学发现。

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摘要

We report a 27-week, 850 g infant with severe Streptococcus group B sepsis and life-threatening hyperkalemia due to progressive anuria. On the fourth day of life, after he failed treatment with diuretics, salbutamol, insulin, calcium gluconate and sodium bicarbonate, he was treated with sorbitol-free Kayexalate enemas. Potassium level slowly decreased from 9.2 mmol/l to normal level along with a recovery of normal urine output. On the 11th day of life, clinical and radiological signs of a perforated necrotizing enterocolitis (NEC) occurred and the patient required surgical intestinal resection. Histologic examination of the ileum specimen revealed areas of necrosis with fibrosis and giant cell reaction to a nonpolarizable material consistent with sodium polystyrene sulfonate. Usually, Kayexalate is suspended in hyperosmolar sorbitol solutions and the elevated osmolarity seems to be responsible for hemorrhagic colitis, transmural necrosis and definitely NEC. Our case report shows that Kayexalate per se,and not necessarily suspended in sorbitol, can lead to gastrointestinal tract complications and NEC in preterm infants.
机译：我们报告了一个27周的850 g婴儿，患有严重的B型链球菌败血症和由于进行性无尿而危及生命的高钾血症。生命的第四天，他在使用利尿剂，沙丁胺醇，胰岛素，葡萄糖酸钙和碳酸氢钠治疗失败后，接受了无山梨糖醇的Kayexalate灌肠剂治疗。钾水平从9.2 mmol / l缓慢下降至正常水平，并恢复正常尿量。在生命的第11天，发生了穿孔性坏死性小肠结肠炎（NEC）的临床和放射学体征，患者需要进行手术肠切除。回肠标本的组织学检查显示坏死区域有纤维化，并且对与聚苯乙烯磺酸钠一致的非极化材料产生巨细胞反应。通常，Kayexalate悬浮在高渗山梨糖醇溶液中，渗透压升高似乎是出血性结肠炎，透壁坏死甚至NEC的原因。我们的病例报告显示，开瑞沙酯本身（不一定悬浮在山梨糖醇中）可导致早产儿胃肠道并发症和NEC。

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