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Citation:
Keshavamurthy J, Bell D, Murphy A, et al. Lanthanum therapy. Reference article, Radiopaedia.org (Accessed on 17 Jan 2025) https://doi.org/10.53347/rID-68978
Lanthanum therapy is used to treat hyperphosphatemia in end-stage renal disease 1. It is taken as oral tablets (usually in the chemical form lanthanum carbonate) which dissociate in the acidic environment of the stomach. The released trivalent lanthanum cation has a high affinity for dietary phosphate. As lanthanum is poorly absorbed in the gut, the phosphate is excreted rectally 5.
Lanthanum is a naturally occurring rare earth element with atomic number 57, one atomic number higher than barium. Lanthanum strongly absorbs x-rays and has contrast medium-like properties 6.
Clinical presentation
Abdominal pain and constipation are common complications 5. It has been proposed that abdominal radiographs can be used to assess patient compliance 2,8.
Radiographic features
Radiography will demonstrate radiopaque deposits within the entire gastrointestinal tract, particularly the colon 1,2,6. This can be mistaken for retained barium or geophagia. Lanthanum is known to cause beam hardening on CT 7.
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1. Cerny S, Kunzendorf U. Images in clinical medicine. Radiographic appearance of lanthanum. (2006) The New England journal of medicine. 355 (11): 1160. doi:10.1056/NEJMicm050535 - Pubmed
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2.Pafčugová, J, Horáčková, M, Hrašková, M, Forejt, J, Szabo, M, Pádr, R. Radio-opaque appearance of lanthanum carbonate in a patient with chronic renal failure. (2008) Nephrology Dialysis Transplantation. 23 (5): 1776. doi:10.1093/ndt/gfn015 - Pubmed
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3. Salerno D, Colin PE, Ernotte C, Dubois B, Meunier P. The Risk of Mistaking Intestinal Lanthanum Carbonate for Intestinal Bleeding on CT. (2015) Journal of the Belgian Society of Radiology. 99 (1): 87-88. doi:10.5334/jbr-btr.852 - Pubmed
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4. Das T, Sharma A, Talukder G. Effects of lanthanum in cellular systems. A review. (1988) Biological trace element research. 18: 201-28. Pubmed
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5. Monique P. Curran, Dean M. Robinson. Lanthanum Carbonate. Drugs. 69 (16): 2329. doi:10.2165/11202610-000000000-00000
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6. Hofmann U, Beer M. Colonic opacification in a patient with end-stage kidney disease. (2010) Gastroenterology. 139 (3): e8-9. doi:10.1053/j.gastro.2009.10.066 - Pubmed
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7. Hayashi H, Machida M, Sekine T, Yamaguchi H, Kiriyama T, Kumita S. Beam-hardening artifacts on computed tomography images caused by lanthanum carbonate hydrate in a patient on dialysis. (2010) Japanese journal of radiology. 28 (4): 322-4. doi:10.1007/s11604-010-0426-0 - Pubmed
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8. David S, Kirchhoff T, Haller H, Meier M. Heavy metal--rely on gut feelings: novel diagnostic approach to test drug compliance in patients with lanthanum intake. (2007) Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 22 (7): 2091-2. doi:10.1093/ndt/gfm208 - Pubmed
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