61 year old man known to have end stage renal disease presented with an episode of rectal bleeding. Colonoscopy: 2x2cm ulcer in the ileocecal valve, biopsy taken. Samples sent for gene expert and TB culture studies was negative. Histopathology: Ileocecal mucosa showed ulceration; Focally few rectangular, rhomboid shaped, basophilic, non polarizable crystals with mosaic/fish scale appearance seen in the lamina propria inflammatory granulation tissue. No evidence of granuloma, parasites,vasculitis, dysplasia/malignancy. The histomorphology of the crystals is characteristic of Kayexalate/K-Bind.