RESUMEN
El carbonato de lantano es un quelante de fósforo no cálcico utilizado en el tratamiento de la hiperfosfatemia asociada a la enfermedad renal crónica. Los depósitos de lantano en la pared gastrointestinal han sido descritos desde 2015. Su significado clínico es incierto. Describimos un caso de paciente varón de 62 años con enfermedad renal crónica en tratamiento con carbonato de lantano durante 3 años, quien presentó depósitos en la mucosa gástrica biopsiada por dispepsia. Los depósitos se observaban como material acelular, con formas irregulares, rodeados de macrófagos y con reacción gigantocelular. Se confirmó la presencia de lantano en los depósitos mediante estudio de espectroscopia de rayos X. En su diagnóstico diferencial con otros depósitos, la clave para hacer su correcta identificación es la realización de una detallada historia clínica que incluya medicamentos administrados y el conocimiento de su aspecto microscópico
Lanthanum carbonate is a non-calcium phosphorus chelator used in the treatment of hyperphosphatemia associated with chronic renal disease. Deposits of lanthanum in the gastrointestinal wall have been recently described but its clinical significance is uncertain. We present a case of a 62-year-old male with chronic renal disease treated with lanthanum carbonate for 3 years, with deposits in his gastric mucosa, found on biopsy for dyspepsia. The deposits were acellular and of irregular shape, surrounded by macrophages and foreign body giant cells. The presence of lanthanum in the deposits was confirmed by X-ray spectroscopy. Diagnosis is reached with knowledge of its microscopic appearance and a thorough clinical history
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Lantano/efectos adversos , Mucosa Gástrica/patología , Neoplasia Endocrina Múltiple Tipo 1/patología , Insuficiencia Renal Crónica/complicaciones , Histiocitosis/patología , Biopsia/métodos , Hiperfosfatemia/tratamiento farmacológicoRESUMEN
Lanthanum carbonate is a non-calcium phosphorus chelator used in the treatment of hyperphosphatemia associated with chronic renal disease. Deposits of lanthanum in the gastrointestinal wall have been recently described but its clinical significance is uncertain. We present a case of a 62-year-old male with chronic renal disease treated with lanthanum carbonate for 3 years, with deposits in his gastric mucosa, found on biopsy for dyspepsia. The deposits were acellular and of irregular shape, surrounded by macrophages and foreign body giant cells. The presence of lanthanum in the deposits was confirmed by X-ray spectroscopy. Diagnosis is reached with knowledge of its microscopic appearance and a thorough clinical history.
