Delayed ileal perforation from sodium polystyrene  sulfonate

A 66-year-old man, without a significant medical history, was admitted to the hospital for polyarthralgia. He reported hemorrhagic diarrhea and having been treated with amoxicillin and metronidazole a month prior to admission. Reactive arthritis was first suspected. His serum creatinine level was 0.759 mg/dl. He received nonsteroidal anti-inflammatory drugs. After 3 days, he was admitted to our unit with acute kidney  failure. His serum creatinine level was 8.932 mg/dl. Proteinase-3 anti-neutrophil cytoplasmic antibodies were strongly positive, and granulomatosis with polyangiitis was confirmed by kidney biopsy.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Image Source Type: research