Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 7008558, Japan.
Central Research Laboratory, Okayama University Medical School, Okayama 7008558, Japan.
World J Gastroenterol. 2020 Apr 7;26(13):1439-1449. doi: 10.3748/wjg.v26.i13.1439.
Lanthanum carbonate is used for treatment of hyperphosphatemia mostly in patients with chronic renal failure. Although lanthanum carbonate is safe, recently, lanthanum deposition in the gastrointestinal mucosa of patients has been reported in the literature. This review provides an overview of gastroduodenal lanthanum deposition and focuses on disease's endoscopic, radiological, and histological features, prevalence, and outcome, by reviewing relevant clinical studies, case reports, and basic research findings, to better understand the endoscopic manifestation of gastrointestinal lanthanum deposition. The possible relationship between gastric lanthanum deposition pattern and gastric mucosal atrophy is also illustrated; in patients without gastric mucosal atrophy, gastric lanthanum deposition appears as diffuse white lesions in the posterior wall and lesser curvature of the gastric body. In the gastric mucosa with atrophy, lanthanum-related lesions likely appear as annular or granular whitish lesions. Moreover, these white lesions are probably more frequently observed in the lower part of the stomach, where intestinal metaplasia begins.
碳酸镧主要用于治疗慢性肾衰竭患者的高磷血症。虽然碳酸镧是安全的，但最近文献中报道了患者胃肠道黏膜中的镧沉积。本综述通过复习相关的临床研究、病例报告和基础研究结果，概述了胃十二指肠镧沉积，并重点介绍了疾病的内镜、放射学和组织学特征、患病率和结局，以便更好地了解胃肠道镧沉积的内镜表现。还说明了胃镧沉积模式与胃黏膜萎缩之间的可能关系；在无胃黏膜萎缩的患者中，胃镧沉积表现为胃体后壁和小弯的弥漫性白色病变。在有萎缩的胃黏膜中，镧相关病变可能表现为环形或颗粒状白色病变。此外，这些白色病变可能更常出现在胃的下部，即肠化生开始的部位。
