Relationship between gastric lanthanum deposition and <i>Helicobacter pylori</i>‐associated chronic gastritis: is it rare or common?

et al. 2020

BMC Gastroenterol

Background There are often specific endoscopic findings caused by deposition of lanthanum (La) in the gastric mucosa of patients taking lanthanum carbonate (LaC), a novel phosphate binder for patients on hemodialysis. We conducted a retrospective study to investigate the clinical significance of La deposition in the gastric mucosa, and the association between endoscopic features and histologic findings in the same population. Methods We compared background factors in patients taking LaC with and without La deposition in their gastroscopic biopsy specimen. We also investigated the relationship between gastric endoscopic biopsy specimens with La deposition and the concurrent endoscopic images. Results There was a significant difference in the total dose of LaC between the La-positive and La-negative groups (990 g [180–3150 g] vs. 480 g [225–1328 g]; p = 0.013). In 27 biopsy specimens with specific whitish mucosa, 10 showed mild histiocytic infiltration and 17 showed severe infiltration. In contrast, among 24 specimens with non-whitish mucosa, 5 showed no histiocytic infiltration, 10 showed mild infiltration, and 9 showed severe infiltration. There was a significant relationship between endoscopic features and the degree of histiocytic infiltration (p = 0.026). Conclusions We demonstrated that La deposition in the gastric mucosa depended on the total dose of LaC and was not affected by background factors. The specific endoscopic features of La deposition are associated with the infiltration of histiocytes, which represents the body’s normal response to foreign bodies. Trial registry The protocol was registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000038929, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000044393).

Section: Discussionmentioning

confidence: 99%

Investigation of the clinical significance and pathological features of lanthanum deposition in the gastric mucosa

et al. 2020

BMC Gastroenterol

Section: Discussionmentioning

confidence: 99%

Investigation of the Clinical Significance and Pathological Features of Lanthanum Deposition in the Gastric Mucosa

et al. 2020

Preprint

Background: There are often specific endoscopic findings caused by deposition of lanthanum (La) in the gastric mucosa of patients taking lanthanum carbonate (LaC), a novel phosphate binder for patients on hemodialysis. We conducted a retrospective study to investigate the clinical significance of Ladeposition in the gastric mucosa, and the association between endoscopic features and histologic findings in the same population.Methods:We compared background factors in patients taking LaC with and without Ladeposition in their gastroscopic biopsy specimen. We also investigated the relationship between gastric endoscopic biopsy specimens with Ladeposition and the concurrent endoscopic images.Results:There was a significant difference in the total dose of LaC between the La-positive and La-negative groups(990 g [180–3150 g] vs. 480 g [225–1328 g]; p=0.013). In 27 biopsy specimens with specific whitish mucosa, 10 showed mild histiocytic infiltration and 17 showed strong infiltration. In contrast, among 24 specimens with non-whitishmucosa, five showed no histiocytic infiltration, 10 showed mild infiltration, and nine showed strong infiltration. There was a significant relationship between endoscopic features and the degree of histiocytic infiltration (p=0.026).Conclusions: We demonstrated that Ladeposition in the gastric mucosa depended on the total dose of LaC and was not affected by background factors. The specific endoscopic features of Ladeposition are associated with the infiltration of histiocytes, which represents the body’s normal response to foreign bodies.The protocol was registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000038929).

“…In addition, concomitant drugs (PPIs, H2RAs, NSAIDs, and gastric mucoprotective drugs) did not affect the deposition of La in the gastric mucosa. Although Shitomi et al reported that the histological nding of Helicobacter pylori infection might decrease the deposition of La [5], Ban et al reported that the lesions associated with Helicobacter pylori infection, such as intestinal metaplasia, regenerative changes, and foveolar hyperplasia, were more frequently observed in mucosa with large quantities of La deposits [6,7]. Given that our present study also showed that the range of atrophic changes in the gastric mucosa was not associated with La deposition, Helicobacter pylori infection may not be associated with the deposition of La in the gastric mucosa.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the clinical significance and pathological features of lanthanum deposition in the gastric mucosa

et al. 2020

Preprint

Background: There are often specific endoscopic findings caused by deposition of lanthanum (La) in the gastric mucosa of patients taking lanthanum carbonate (LaC), a novel phosphate binder for patients on hemodialysis. We conducted a retrospective study to investigate the clinical significance of La deposition in the gastric mucosa, and the association between endoscopic features and histologic findings in the same population.Methods: We compared background factors in patients taking LaC with and without La deposition in their gastroscopic biopsy specimen. We also investigated the relationship between gastric endoscopic biopsy specimens with La deposition and the concurrent endoscopic images.Results: There was a significant difference in the total dose of LaC between the La-positive and La-negative groups (990 g [180–3150 g] vs. 480 g [225–1328 g]; p=0.013). In 27 biopsy specimens with specific whitish mucosa, 10 showed mild histiocytic infiltration and 17 showed severe infiltration. In contrast, among 24 specimens with non-whitish mucosa, 5 showed no histiocytic infiltration, 10 showed mild infiltration, and 9 showed severe infiltration. There was a significant relationship between endoscopic features and the degree of histiocytic infiltration (p=0.026).Conclusions: We demonstrated that La deposition in the gastric mucosa depended on the total dose of LaC and was not affected by background factors. The specific endoscopic features of La deposition are associated with the infiltration of histiocytes, which represents the body’s normal response to foreign bodies.