Investigation of deposition of lanthanum on gastric mucosa in hemodialysis patients with lanthanum therapy

Namie, Satoru; Hamabe, Sadanori; Kawatomi, Masaharu; Kawatomi, Masahiro; Oda, Hidetoshi; Nakazawa, Minato; Nishino, Tomoya

doi:10.4009/jsdt.48.169

Cited by 10 publications

(27 citation statements)

References 16 publications

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“…In this study, La deposition was detected as HD‐LA on CT examination in 11 patients (79%). The positive rate in this study was higher than in a previous study (60%) . The difference might be due to the presence or absence of withdrawal for a week.…”

Section: Discussioncontrasting

confidence: 82%

“…We named this under‐recognized condition “gastric lanthanosis” and defined it as La deposition in the gastric mucosa of dialysis patients treated with LaC. There were several previous studies on gastric lanthanosis, but most of these were case reports from Japan . The present report is the first comprehensive study with a proposed mechanism.…”

Section: Discussionmentioning

confidence: 87%

“…To date, serious signs and symptoms related to gastric lanthanosis have not been reported. Follow‐up data after stopping administration of LaC was described in three patients . In these reports, La deposition vanished or markedly decreased after 3–8 months.…”

Section: Discussionmentioning

confidence: 99%

“…However lanthanum (La) deposition in the liver and bone has been reported in animal experiments . Contrary to conventional wisdom, there have been several reports of La deposition in the human gastric mucosa of dialysis patients treated with LaC since 2015 . In 2009, an autopsy report of a case of nephrogenic systemic fibrosis with La deposition in the mesenteric lymph nodes was published, but findings in the stomach were not described .…”

mentioning

confidence: 99%

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Gastric lanthanosis (lanthanum deposition) in dialysis patients treated with lanthanum carbonate

Yuki

Nishida

Kusaba

et al. 2017

Pathology International

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Lanthanum carbonate (LaC) is used to prevent hyperphosphatemia in dialysis patients. It is commonly believed that there is little LaC absorption from the intestines. However, La deposition in the gastric mucosa, which we coined "gastric lanthanosis", was recently reported. We describe here the clinicopathological features of and a possible mechanism for gastric lanthanosis. This study included 23 patients with definite gastric lanthanosis. We extracted characteristic clinicopathological features of gastric lanthanosis by computed tomography (CT) imaging and endoscopic, histologic, electron-microscopic, and element analysis examinations. The Helicobacter pylori infection rate in the lanthanosis group was much lower than that among the general population. The clinicopathological features characteristic of gastric lanthanosis were mucosal high-density linear appearance by CT, reflective bright-white spots (BWS) by gastroscopy, eosinophilic histiocytes occasionally phagocytizing foreign materials by histology, and numerous electron-dense particles in the histiocytes. The particles had burr-like skeletons resembling La crystals. Gastric lanthanosis is an under-reported, but not a rare lesion. It is characterized by endoscopic BWS and histologic eosinophilic histiocytes in dialysis patients treated with LaC. The proposed mechanism for gastric lanthanosis is that LaC is dissolved by gastric juice, crystallized within the mucosa and is phagocytized by histiocytes.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Gastric lanthanosis (lanthanum deposition) in dialysis patients treated with lanthanum carbonate

Yuki

Nishida

Kusaba

et al. 2017

Pathology International

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“…Thus, the long-term safety of LC treatment, especially in clinical practice, has not been completely established. In recent years, several case reports about La deposition in gastric mucosa have been published [22][23][24][25]. Although Data are given as mean ± standard deviation (n) CI confidence interval V.S.…”

Section: Discussionmentioning

confidence: 99%

Long-term observational study in Japanese hemodialysis patients who completed a 3-year clinical study of lanthanum carbonate

2016

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Gastric lanthanosis (lanthanum deposition) in an immunosuppressed patient that discontinued lanthanum carbonate seven years ago

Ullmann¹,

Erbersdobler²

2021

Clinical Case Reports

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A 72‐year‐old female patient used the oral phosphate binder lanthanum carbonate for 6 years, before discontinuing it after receiving a pancreas and kidney transplant. Now, 7 years after discontinuation, the patient developed bilious emesis. An upper gastrointestinal endoscopy showed an unspecific gastritis. Biopsies showed subepithelial crystalline deposits consistent with gastric lanthanosis.

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Investigation of deposition of lanthanum on gastric mucosa in hemodialysis patients with lanthanum therapy

Cited by 10 publications

References 16 publications

Gastric lanthanosis (lanthanum deposition) in dialysis patients treated with lanthanum carbonate

Gastric lanthanosis (lanthanum deposition) in dialysis patients treated with lanthanum carbonate

Long-term observational study in Japanese hemodialysis patients who completed a 3-year clinical study of lanthanum carbonate

Gastric lanthanosis (lanthanum deposition) in an immunosuppressed patient that discontinued lanthanum carbonate seven years ago

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