Lanthanum phosphate binder-induced iron deficiency anaemia
Lanthanum carbonate is a phosphate binder that is used to reduce serum phosphate levels in patients with end-stage renal disease (ESRD). Lanthanum forms insoluble lanthanum phosphate complexes that are supposed to pass through the gastrointestinal (GI) tract unabsorbed. Phosphate binders have been r...
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| Veröffentlicht in: | BMJ case reports 2019-03, Vol.12 (3), p.e226157 |
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| creator | Awad, Christina Gilkison, Karin Shaw, Erwin |
| description | Lanthanum carbonate is a phosphate binder that is used to reduce serum phosphate levels in patients with end-stage renal disease (ESRD). Lanthanum forms insoluble lanthanum phosphate complexes that are supposed to pass through the gastrointestinal (GI) tract unabsorbed. Phosphate binders have been reported to deposit in the GI tract and can cause mucosal injury. There are few case reports of GI bleeding associated with phosphate binder deposits. This case report presents a patient with iron deficiency anaemia secondary to biopsy-proven lanthanum deposits in the upper GI tract. There were no overt signs of active GI bleeding. Patient’s anaemia improved with discontinuation of the phosphate binder. Lanthanum could be a hidden cause of resistant anaemia among patients with ESRD through asymptomatic GI blood loss. |
| doi_str_mv | 10.1136/bcr-2018-226157 |
| format | Article |
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Lanthanum forms insoluble lanthanum phosphate complexes that are supposed to pass through the gastrointestinal (GI) tract unabsorbed. Phosphate binders have been reported to deposit in the GI tract and can cause mucosal injury. There are few case reports of GI bleeding associated with phosphate binder deposits. This case report presents a patient with iron deficiency anaemia secondary to biopsy-proven lanthanum deposits in the upper GI tract. There were no overt signs of active GI bleeding. Patient’s anaemia improved with discontinuation of the phosphate binder. Lanthanum could be a hidden cause of resistant anaemia among patients with ESRD through asymptomatic GI blood loss.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2018-226157</identifier><identifier>PMID: 30878952</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abdomen ; Aged ; Anemia ; Anemia, Iron-Deficiency - chemically induced ; Case reports ; Chronic illnesses ; Colonoscopy ; Comorbidity ; Diabetes ; Endoscopy ; Esophagus ; Gastric Mucosa - injuries ; Hemodialysis ; Hemoglobin ; Humans ; Hyperphosphatemia - drug therapy ; Hyperphosphatemia - etiology ; Iron ; Kidney diseases ; Kidney Failure, Chronic - complications ; Lanthanum - adverse effects ; Male ; Mucous membrane ; Patients ; Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions</subject><ispartof>BMJ case reports, 2019-03, Vol.12 (3), p.e226157</ispartof><rights>BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2019 BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b456t-c502e452669dc2bcc5ef724cd7019f609db7438012b32d0c4e5ffd182fd5a9c73</citedby><cites>FETCH-LOGICAL-b456t-c502e452669dc2bcc5ef724cd7019f609db7438012b32d0c4e5ffd182fd5a9c73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424195/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424195/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30878952$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Awad, Christina</creatorcontrib><creatorcontrib>Gilkison, Karin</creatorcontrib><creatorcontrib>Shaw, Erwin</creatorcontrib><title>Lanthanum phosphate binder-induced iron deficiency anaemia</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>Lanthanum carbonate is a phosphate binder that is used to reduce serum phosphate levels in patients with end-stage renal disease (ESRD). Lanthanum forms insoluble lanthanum phosphate complexes that are supposed to pass through the gastrointestinal (GI) tract unabsorbed. Phosphate binders have been reported to deposit in the GI tract and can cause mucosal injury. There are few case reports of GI bleeding associated with phosphate binder deposits. This case report presents a patient with iron deficiency anaemia secondary to biopsy-proven lanthanum deposits in the upper GI tract. There were no overt signs of active GI bleeding. Patient’s anaemia improved with discontinuation of the phosphate binder. Lanthanum could be a hidden cause of resistant anaemia among patients with ESRD through asymptomatic GI blood loss.</description><subject>Abdomen</subject><subject>Aged</subject><subject>Anemia</subject><subject>Anemia, Iron-Deficiency - chemically induced</subject><subject>Case reports</subject><subject>Chronic illnesses</subject><subject>Colonoscopy</subject><subject>Comorbidity</subject><subject>Diabetes</subject><subject>Endoscopy</subject><subject>Esophagus</subject><subject>Gastric Mucosa - injuries</subject><subject>Hemodialysis</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hyperphosphatemia - drug therapy</subject><subject>Hyperphosphatemia - etiology</subject><subject>Iron</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Lanthanum - adverse effects</subject><subject>Male</subject><subject>Mucous membrane</subject><subject>Patients</subject><subject>Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkM1LwzAYh4MobujO3qTgTahL0qRpPAgy_IKBFwVvIZ-2Y01r2gr7783oHPNkDm8Ced7f-_IAcIHgDUJZPlc6pBiiIsU4R5QdgSlilKWMw4_jg_cEzLpuBePJEClIdgomGSxYwSmegtul9H0p_VAnbdl0bSl7m6jKGxvSWAdtTVKFxifGukpX1utNIr20dSXPwYmT687OdvcZeH98eFs8p8vXp5fF_TJVhOZ9qinEllCc59xorLSm1jFMtGEQcZdDbhQjWQERVhk2UBNLnTOowM5QyTXLzsDdmNsOqrZGW98HuRZtqGoZNqKRlfj746tSfDbfIieYIE5jwNUuIDRfg-16sWqG4OPOAiNOGISEZ5Gaj5QOTdcF6_YTEBRb3yL6FlvfYvQdOy4PF9vzv3YjcD0Cql79m_YDlEuJYQ</recordid><startdate>20190301</startdate><enddate>20190301</enddate><creator>Awad, Christina</creator><creator>Gilkison, Karin</creator><creator>Shaw, Erwin</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20190301</creationdate><title>Lanthanum phosphate binder-induced iron deficiency anaemia</title><author>Awad, Christina ; Gilkison, Karin ; Shaw, Erwin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b456t-c502e452669dc2bcc5ef724cd7019f609db7438012b32d0c4e5ffd182fd5a9c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdomen</topic><topic>Aged</topic><topic>Anemia</topic><topic>Anemia, Iron-Deficiency - chemically induced</topic><topic>Case reports</topic><topic>Chronic illnesses</topic><topic>Colonoscopy</topic><topic>Comorbidity</topic><topic>Diabetes</topic><topic>Endoscopy</topic><topic>Esophagus</topic><topic>Gastric Mucosa - injuries</topic><topic>Hemodialysis</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hyperphosphatemia - drug therapy</topic><topic>Hyperphosphatemia - etiology</topic><topic>Iron</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Lanthanum - adverse effects</topic><topic>Male</topic><topic>Mucous membrane</topic><topic>Patients</topic><topic>Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Awad, Christina</creatorcontrib><creatorcontrib>Gilkison, Karin</creatorcontrib><creatorcontrib>Shaw, Erwin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Awad, Christina</au><au>Gilkison, Karin</au><au>Shaw, Erwin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lanthanum phosphate binder-induced iron deficiency anaemia</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>12</volume><issue>3</issue><spage>e226157</spage><pages>e226157-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>Lanthanum carbonate is a phosphate binder that is used to reduce serum phosphate levels in patients with end-stage renal disease (ESRD). Lanthanum forms insoluble lanthanum phosphate complexes that are supposed to pass through the gastrointestinal (GI) tract unabsorbed. Phosphate binders have been reported to deposit in the GI tract and can cause mucosal injury. There are few case reports of GI bleeding associated with phosphate binder deposits. This case report presents a patient with iron deficiency anaemia secondary to biopsy-proven lanthanum deposits in the upper GI tract. There were no overt signs of active GI bleeding. Patient’s anaemia improved with discontinuation of the phosphate binder. Lanthanum could be a hidden cause of resistant anaemia among patients with ESRD through asymptomatic GI blood loss.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>30878952</pmid><doi>10.1136/bcr-2018-226157</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Aged Anemia Anemia, Iron-Deficiency - chemically induced Case reports Chronic illnesses Colonoscopy Comorbidity Diabetes Endoscopy Esophagus Gastric Mucosa - injuries Hemodialysis Hemoglobin Humans Hyperphosphatemia - drug therapy Hyperphosphatemia - etiology Iron Kidney diseases Kidney Failure, Chronic - complications Lanthanum - adverse effects Male Mucous membrane Patients Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions |
| title | Lanthanum phosphate binder-induced iron deficiency anaemia |
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