Abstract
Objective This study aimed to investigate the endoscopic features of lanthanum-associated duodenal lesions and the prevalence of duodenal involvement among patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Methods We retrospectively reviewed 24 patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Patients were subdivided into three groups: Group A, patients with pathologicallyproven lanthanum deposition in the duodenum; Group B, patients without lanthanum deposition in the duodenum; and Group C, patients without a biopsy of the duodenum. Results A biopsy examination of the duodenum was performed in 19 patients, and lanthanum deposition was detected in 17 patients (17/19, 89.5%). In group A (n=17), whitish duodenal villi were detected in 15 patients during esophagogastroduodenoscopy (15/17, 88.2%). While the other two patients showed no whitish villi, a biopsy of the duodenal mucosa revealed lanthanum deposition. The deposition of a white substance showing a clear margin was visible within multiple villi under magnified observation in some patients of group A. Group B patients (n=2) also showed whitish villi. However, the whitish color was faint in one case and sparse in the other case. Conclusion Lanthanum deposits in the duodenum may resemble white villi. However, in some cases, these deposits may be unrecognizable during esophagogastroduodenoscopy due to the subtle degree of deposition. Endoscopists should biopsy the duodenum as well as the stomach, regardless of the presence or absence of white villi, for an accurate determination of lanthanum deposition in the gastrointestinal tract.
| Original language | English |
|---|---|
| Pages (from-to) | 2283-2289 |
| Number of pages | 7 |
| Journal | Internal Medicine |
| Volume | 58 |
| Issue number | 16 |
| DOIs | |
| Publication status | Published - Jan 1 2019 |
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Keywords
- Esophagogastroduodenoscopy
- hyperphosphatemia
- Lanthanum carbonate
- Scanning electron microscopic analysis
ASJC Scopus subject areas
- Internal Medicine
Cite this
Frequent involvement of the duodenum with lanthanum deposition : A retrospective observational study. / Iwamuro, Masaya; Urata, Haruo; Tanaka, Takehiro; Kawano, Seiji; Kawahara, Yoshiro; Okada, Hiroyuki.
In: Internal Medicine, Vol. 58, No. 16, 01.01.2019, p. 2283-2289.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Frequent involvement of the duodenum with lanthanum deposition
T2 - A retrospective observational study
AU - Iwamuro, Masaya
AU - Urata, Haruo
AU - Tanaka, Takehiro
AU - Kawano, Seiji
AU - Kawahara, Yoshiro
AU - Okada, Hiroyuki
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objective This study aimed to investigate the endoscopic features of lanthanum-associated duodenal lesions and the prevalence of duodenal involvement among patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Methods We retrospectively reviewed 24 patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Patients were subdivided into three groups: Group A, patients with pathologicallyproven lanthanum deposition in the duodenum; Group B, patients without lanthanum deposition in the duodenum; and Group C, patients without a biopsy of the duodenum. Results A biopsy examination of the duodenum was performed in 19 patients, and lanthanum deposition was detected in 17 patients (17/19, 89.5%). In group A (n=17), whitish duodenal villi were detected in 15 patients during esophagogastroduodenoscopy (15/17, 88.2%). While the other two patients showed no whitish villi, a biopsy of the duodenal mucosa revealed lanthanum deposition. The deposition of a white substance showing a clear margin was visible within multiple villi under magnified observation in some patients of group A. Group B patients (n=2) also showed whitish villi. However, the whitish color was faint in one case and sparse in the other case. Conclusion Lanthanum deposits in the duodenum may resemble white villi. However, in some cases, these deposits may be unrecognizable during esophagogastroduodenoscopy due to the subtle degree of deposition. Endoscopists should biopsy the duodenum as well as the stomach, regardless of the presence or absence of white villi, for an accurate determination of lanthanum deposition in the gastrointestinal tract.
AB - Objective This study aimed to investigate the endoscopic features of lanthanum-associated duodenal lesions and the prevalence of duodenal involvement among patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Methods We retrospectively reviewed 24 patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Patients were subdivided into three groups: Group A, patients with pathologicallyproven lanthanum deposition in the duodenum; Group B, patients without lanthanum deposition in the duodenum; and Group C, patients without a biopsy of the duodenum. Results A biopsy examination of the duodenum was performed in 19 patients, and lanthanum deposition was detected in 17 patients (17/19, 89.5%). In group A (n=17), whitish duodenal villi were detected in 15 patients during esophagogastroduodenoscopy (15/17, 88.2%). While the other two patients showed no whitish villi, a biopsy of the duodenal mucosa revealed lanthanum deposition. The deposition of a white substance showing a clear margin was visible within multiple villi under magnified observation in some patients of group A. Group B patients (n=2) also showed whitish villi. However, the whitish color was faint in one case and sparse in the other case. Conclusion Lanthanum deposits in the duodenum may resemble white villi. However, in some cases, these deposits may be unrecognizable during esophagogastroduodenoscopy due to the subtle degree of deposition. Endoscopists should biopsy the duodenum as well as the stomach, regardless of the presence or absence of white villi, for an accurate determination of lanthanum deposition in the gastrointestinal tract.
KW - Esophagogastroduodenoscopy
KW - hyperphosphatemia
KW - Lanthanum carbonate
KW - Scanning electron microscopic analysis
UR - http://www.scopus.com/inward/record.url?scp=85071350412&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071350412&partnerID=8YFLogxK
U2 - 10.2169/internalmedicine.2398-18
DO - 10.2169/internalmedicine.2398-18
M3 - Article
C2 - 31118380
AN - SCOPUS:85071350412
VL - 58
SP - 2283
EP - 2289
JO - Internal Medicine
JF - Internal Medicine
SN - 0918-2918
IS - 16
ER -