Radiographic Appearance of Lanthanum

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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

    http://www.100md.com/html/DirDu/2007/01/01/33/21/64.htm