Clinical Characteristics of Seven Patients with Lanthanum Phosphate Deposition in the Stomach

• Published in: Internal Medicine Vol. 56; no. 16; pp. 2089 - 2095
• Main Authors: Murakami, Naoko, Yoshioka, Masao, Iwamuro, Masaya, Nasu, Junichirou, Nose, Soichiro, Shiode, Junji, Okada, Hiroyuki, Yamamoto, Kazuhide
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2017; Japan Science and Technology Agency
• Subjects: Aged; Appetite loss; Atrophy; chronic kidney disease; Complications; Deposition; Endoscopy; Female; Hemodialysis; Humans; hyperphosphatemia; Hyperphosphatemia - diagnostic imaging; Hyperphosphatemia - drug therapy; Hyperphosphatemia - etiology; Hyperphosphatemia - pathology; Internal medicine; Japan; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Lanthanide phosphates; Lanthanum; Lanthanum - analysis; Lanthanum - therapeutic use; lanthanum carbonate; Lesions; Male; Males; Middle Aged; Mucosa; Original; Pathogenicity; Pathogens; Patients; Peritoneal dialysis; Peritoneum; Phosphates; Phosphates - analysis; Renal Dialysis - adverse effects; Retrospective Studies; Stomach; Stomach - chemistry; Swallowing; lanthanum carbonate; hyperphosphatemia; chronic kidney disease
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.8720-16

Objective To analyze the clinical characteristics and endoscopic features of patients with lanthanum deposition in the stomach. Patients We retrospectively reviewed seven patients with lanthanum deposition in the stomach who were diagnosed at Okayama Saiseikai General Hospital. We investigated the patient sex, age at diagnosis, medical and medication histories, gastrointestinal symptoms, complications, presence or absence of gastric atrophy, and outcome. We also investigated any changes in the endoscopic features if previous endoscopic images were available. Results Seven patients (six males and one female) had lanthanum deposition. The median age was 65 years (range, 50-79 years). All patients had been undergoing dialysis (continuous ambulatory peritoneal dialysis in one patient, hemodialysis in six patients). The dialysis period ranged from 16 to 73 months (median, 52 months). The patients had all been taking lanthanum carbonate for a period ranging from 5 to 45 months (median, 27 months). Gastric atrophy was noted in 6 patients (85.7%). One patient had difficulty swallowing, and 1 other patient had appetite loss. The other 5 patients were asymptomatic. Endoscopic features included annular whitish mucosa (n = 4), diffuse whitish mucosa (n = 3), and whitish spots (n = 2). Five patients underwent multiple esophagogastroduodenoscopy. The endoscopic features were unchanged in 2 patients, whereas the whitish mucosa became apparent and spread during the course in 3 patients. Conclusion We identified 7 patients with lanthanum deposition in the stomach. All patients showed whitish lesions macroscopically. Although the pathogenicity of gastric lanthanum deposition is uncertain, lanthanum-related lesions in the stomach progressed during continuous lanthanum phosphate intake in several patients.