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[StomachTODAY 043. Lanthanum deposition in the stomach]

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투석 환자의 내시경 조직검사 결과가 "Some macrophage clusters with granular materials, suspected lanthanum (related with hemodialysis)"였습니다.

화학원소 란타넘 또는 란탄, 란타늄은 기호는 La, 원자 번호는 57입니다. 란타넘은 은백색의 금속으로 대개 란타넘족으로 분류하는데 세륨이나 희토류 원소와 함께 산출됩니다. 란타넘은 가단성과 연성이 있고, 칼로 자를 수 있을 만큼 무르고 희토류 원소 중에 가장 반응성이 크다고 합니다. 투석환자의 장기에 침착할수 있습니다. 저도 처음 보는 현상이므로 한 case series의 설명을 옮깁니다 (Intern Med. 2017).

Lanthanum carbonate, La2(CO3)3, has been widely used to treat hyperphosphatemia in patients with chronic kidney disease because this agent has a higher efficacy and tolerability compared to other conventional phosphate binders. After consuming lanthanum carbonate with meals, lanthanum binds with dietary phosphate. As a result, the formation of highly insoluble complexes, such as lanthanum phosphate, occurs, and prevents phosphate absorption via the intestine. The gastrointestinal tract minimally absorbs lanthanum phosphate complexes; therefore, most of the lanthanum phosphate is excreted via the feces. Despite its low bioavailability, accumulating evidence shows that lanthanum can be deposited in the gastrointestinal mucosa, particularly in the stomach. Endoscopic features included annular whitish mucosa (n = 4), diffuse whitish mucosa (n = 3), and whitish spots (n = 2).

© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng (2020-6-19)