Images in Clinical Medicine

Radiographic Appearance of Lanthanum

Simon Cerny, M.D., and Ulrich Kunzendorf, M.D.

N Engl J Med 2006; 355:1160September 14, 2006

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An 82-year-old man with hypertension, coronary artery disease, congestive heart failure, chronic constipation, degenerative joint disease of the hips, and a 5-year history of hemodialysis for end-stage renal disease presented with worsening hip pain. The results of his physical examination were unrevealing. Findings on radiography of the pelvis without contrast medium did not provide a reason for his increased hip pain but did show diffuse opacifications throughout the colon. Questioning revealed that his renal failure had induced hyperphosphatemia, which was initially managed with calcium acetate, but 6 months earlier this medication had been changed to lanthanum carbonate (1.5 g orally three times a day). The patient had never previously undergone intestinal radiography with contrast medium. Lanthanum is a metal (rare earth, atomic number, 57; the atomic number of barium is 56) that is being studied for use as a potential nonaluminum and noncalcium phosphate binder; however, as this radiograph shows, it may also potentially be visualized on radiography of the intestine. In this patient, the analgesia for his hip discomfort brought relief, lanthanum was discontinued, and calcium acetate was resumed.

Simon Cerny, M.D.
Ulrich Kunzendorf, M.D.
University of Kiel, D-24105 Kiel, Germany
public@nephro.uni-kiel.de

Citing Articles (10)

Citing Articles

1. 1

   James P. Walsh, Amale A. Lteif. (2011) Lanthanum Carbonate Interference With Lumbar Spine DXA. Journal of Clinical Densitometry 14:4, 499-501
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2. 2

   Maurice Laville. (2011) Efficacité et tolérance du carbonate de lanthane dans le traitement de l’hyperphosphorémie chez le patient insuffisant rénal chronique. Néphrologie & Thérapeutique 7:3, 154-161
   CrossRef

3. 3

   L. Pérez Alonso, M.A. Moreno Palanco. (2011) Carbonato de lantano: una explicación novedosa de una imagen radiológica habitual. Revista Clínica Española 211:1, 60-61
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4. 4

   K. Turkmen, Y. Solak, M. Anil, H. Polat, H. Z. Tonbul. (2010) An unusual hurdle to renal transplantation: speckled abdominal opacities induced by lanthanum carbonate. Internal Medicine Journal 40:12, e1-e2
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5. 5

   Ulrich Hofmann, Meinrad Beer. (2010) Colonic Opacification in a Patient With End-Stage Kidney Disease. Gastroenterology 139:3, e8-e9
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6. 6

   Akihiko Kato, Takako Takita, Mitsuyoshi Furuhashi. (2010) Accumulation of lanthanum carbonate in the digestive tracts. Clinical and Experimental Nephrology 14:1, 100-101
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7. 7

   M. D. L. Smyth, R. D. Pratt. (2009) A confusional state associated with use of lanthanum carbonate in a dialysis patient: a case report. Nephrology Dialysis Transplantation 24:12, 3898-3899
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8. 8

   Simona Brambilla, Serenella Valaperta, Giorgio Graziani, Alessandro Montanelli. (2008) Gadolinium and lanthanum: A iatrogenic transmetallation?. Clinical Biochemistry 41:13, 1029-1033
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9. 9

   Laurence Vrigneaud, Delphine Lefèbvre, Alexandre Olive Daem, Vincent Lemaitre. (2008) Aspects radiographiques de l’absorption digestive du carbonate de lanthane. Néphrologie & Thérapeutique 4:2, 111-113
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10. 10

    Stephen J P Damment, Michael Pennick. (2008) Clinical Pharmacokinetics of the Phosphate Binder Lanthanum Carbonate. Clinical Pharmacokinetics 47:9, 553-563
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