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Background: There are often specific endoscopic findings caused by deposition of lanthanum (La) in the gastric mucosa of patients taking lanthanum carbonate (LaC), a novel phosphate binder for patients on hemodialysis. We conducted a retrospective study to investigate the clinical significance of La deposition in the gastric mucosa, and the association between endoscopic features and histologic findings in the same population.
Methods: We compared background factors in patients taking LaC with and without La deposition in their gastroscopic biopsy specimen. We also investigated the relationship between gastric endoscopic biopsy specimens with La deposition and the concurrent endoscopic images.
Results: There was a significant difference in the total dose of LaC between the La-positive and La-negative groups (990 g [180–3150 g] vs. 480 g [225–1328 g]; p=0.013). In 27 biopsy specimens with specific whitish mucosa, 10 showed mild histiocytic infiltration and 17 showed severe infiltration. In contrast, among 24 specimens with non-whitish mucosa, 5 showed no histiocytic infiltration, 10 showed mild infiltration, and 9 showed severe infiltration. There was a significant relationship between endoscopic features and the degree of histiocytic infiltration (p=0.026).
Conclusions: We demonstrated that La deposition in the gastric mucosa depended on the total dose of LaC and was not affected by background factors. The specific endoscopic features of La deposition are associated with the infiltration of histiocytes, which represents the body’s normal response to foreign bodies.
The protocol was registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000038929).
Keywords
lanthanum, phosphate binder, histiocytic infiltration, whitish lesion
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View the published article at BMC Gastroenterology.
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Submission checks complete
On 20 Nov, 2020
Editorial decision: Accept
On 16 Nov, 2020
Version 2
Posted 06 Nov, 2020
No comments provided
Editor assigned
On 31 Oct, 2020
Submission checks complete
On 31 Oct, 2020
Editor invited
On 31 Oct, 2020
No comments provided
Editorial decision: Major revision
On 27 Oct, 2020
Review #2 received
Received 12 Oct, 2020
Reviewer #2 agreed
On 23 Sep, 2020
Review #1 received
Received 31 Aug, 2020
Reviewer #1 agreed
On 28 Jun, 2020
Reviewers invited
Invitations sent on 23 Jun, 2020
Editor assigned
On 15 May, 2020
First submitted
On 14 May, 2020
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On 14 May, 2020
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Subject Areas
Internal Medicine
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A new preprint design is coming!
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See the published version of this preprint at BMC Gastroenterology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Gastroenterology.
No community comments so far
Submission checks complete
On 20 Nov, 2020
Editorial decision: Accept
On 16 Nov, 2020
Version 2
Posted 06 Nov, 2020
No comments provided
Editor assigned
On 31 Oct, 2020
Submission checks complete
On 31 Oct, 2020
Editor invited
On 31 Oct, 2020
No comments provided
Editorial decision: Major revision
On 27 Oct, 2020
Review #2 received
Received 12 Oct, 2020
Reviewer #2 agreed
On 23 Sep, 2020
Review #1 received
Received 31 Aug, 2020
Reviewer #1 agreed
On 28 Jun, 2020
Reviewers invited
Invitations sent on 23 Jun, 2020
Editor assigned
On 15 May, 2020
First submitted
On 14 May, 2020
Submission checks complete
On 14 May, 2020
Editor invited
On 14 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Internal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Gastroenterology.
Background: There are often specific endoscopic findings caused by deposition of lanthanum (La) in the gastric mucosa of patients taking lanthanum carbonate (LaC), a novel phosphate binder for patients on hemodialysis. We conducted a retrospective study to investigate the clinical significance of La deposition in the gastric mucosa, and the association between endoscopic features and histologic findings in the same population.
Methods: We compared background factors in patients taking LaC with and without La deposition in their gastroscopic biopsy specimen. We also investigated the relationship between gastric endoscopic biopsy specimens with La deposition and the concurrent endoscopic images.
Results: There was a significant difference in the total dose of LaC between the La-positive and La-negative groups (990 g [180–3150 g] vs. 480 g [225–1328 g]; p=0.013). In 27 biopsy specimens with specific whitish mucosa, 10 showed mild histiocytic infiltration and 17 showed severe infiltration. In contrast, among 24 specimens with non-whitish mucosa, 5 showed no histiocytic infiltration, 10 showed mild infiltration, and 9 showed severe infiltration. There was a significant relationship between endoscopic features and the degree of histiocytic infiltration (p=0.026).
Conclusions: We demonstrated that La deposition in the gastric mucosa depended on the total dose of LaC and was not affected by background factors. The specific endoscopic features of La deposition are associated with the infiltration of histiocytes, which represents the body’s normal response to foreign bodies.
The protocol was registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000038929).
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