Gastric mucosal status susceptible to lanthanum deposition in patients treated with dialysis and lanthanum carbonate

Correlation of lanthanum dosage with lanthanum deposition in the gastroduodenal mucosa of dialysis patients

“…In addition mucosal barrier defects are reported in gastric intestinal metaplasia . There seemed to be a relevance between La deposition and mucosal barrier defects like intestinal metaplasia, or the many erosions in our cases and in other reports …”

“…The histological findings suggest that the multinucleated giant cells appeared as a reaction to the crystalloid materials which have unique structures. Although the intestinal absorption of La is lower than that of aluminum, several cases of La deposition including ours have been confirmed by energy dispersive X‐ray spectroscopy, inductively coupled plasma mass spectrometry and ultrastructural examination . In the former case reports several hypotheses of the mechanism of La deposition were proposed as follows: Tonooka suggested that metaplastic changes are associated with La depositions, Haratake suggested the possibility that preformed ulcers aggravated the entry of La into the gastric mucosa, Valika suggested underlying pathology such as gastric vascular ectasia or gastropathy and mucosal erosion induced by non‐steroidal anti‐inflammatory drugs, and Namie suggested examining H. pylori involvement.…”

“…In the former case reports several hypotheses of the mechanism of La deposition were proposed as follows: Tonooka suggested that metaplastic changes are associated with La depositions, Haratake suggested the possibility that preformed ulcers aggravated the entry of La into the gastric mucosa, Valika suggested underlying pathology such as gastric vascular ectasia or gastropathy and mucosal erosion induced by non‐steroidal anti‐inflammatory drugs, and Namie suggested examining H. pylori involvement. Ban et al reported that La deposition tends to occur in gastric mucosa with regenerative changes, intestinal metaplasia, or foveolar hyperplasia. It seemed that there is a relation between La deposition and the mucosal lesions, but the relationship between histological/endoscopical findings and La deposition could not be concluded in our study.…”

Relationship between gastric lanthanum deposition and Helicobacter pylori‐associated chronic gastritis: is it rare or common?

“…Based on this observation, they concluded that the H. pylori infection rate in patients with gastric lanthanum deposition was much lower than that among the general population and speculated that H. pylori infection may prevent lanthanum deposition. In a recent study, Ban et al 2 have reported that lanthanum deposition was identified in 86/121 gastric biopsy specimens (71.1%) obtained from 22 patients who had been administered lanthanum carbonate. Gastric mucosal alterations such as intestinal metaplasia, regenerative change, and foveolar hyperplasia were more frequently observed in mucosa with large quantities of lanthanum deposits.…”

Distribution of lanthanum carbonate in the gastric mucosa confirmed by electron microscopy with a magnified endoscopy: a case report and literature review

“…Histopathologically, lanthanum deposition in the gastric mucosa was first demonstrated by Makino et al in 2015 [2]. To date, numerous case reports have been published on lanthanum deposition [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Previous reports of endoscopic findings of lanthanum deposition in the gastric mucosa have varied widely.…”