Lanthanum Carbonate Opacities—A Systematic Review
Background: Lanthanum carbonate is a phosphate binder used in advanced kidney disease. Its radiopaque appearance has been described in many case studies and case series. Misinterpretation of this phenomenon leads to unnecessary diagnostic tests and procedures. The objectives of this study were to su...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-02-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/12/2/464 |
| _version_ | 1797481160494809088 |
|---|---|
| author | Jan Kampmann Nina Pirschel Hansen Anders Nikolai Ørsted Schultz Andreas Hjelm Brandt Frans Brandt |
| author_facet | Jan Kampmann Nina Pirschel Hansen Anders Nikolai Ørsted Schultz Andreas Hjelm Brandt Frans Brandt |
| author_sort | Jan Kampmann |
| collection | DOAJ |
| description | Background: Lanthanum carbonate is a phosphate binder used in advanced kidney disease. Its radiopaque appearance has been described in many case studies and case series. Misinterpretation of this phenomenon leads to unnecessary diagnostic tests and procedures. The objectives of this study were to summarize the literature on lanthanum carbonate opacities and present a visual overview. Methods: A systematic search was conducted using MEDLINE, Embase, and Web of Science. We included all types of studies, including case reports/studies, describing radiological findings of lanthanum carbonate opacities in patients with chronic kidney disease. No filter for time was set. Results: A total of 36 articles were eligible for data extraction, and 33 articles were included in the narrative synthesis. Lanthanum carbonate opacities were most commonly reported in the intestines (26 studies, 73%), stomach (8 studies, 21%), and the aerodigestive tract (2 studies, 6%). The opacities in the intestine were most frequently described as multiple, scattered radiopaque densities, compared with the aerodigestive tract, where the opacities were described as a single, round foreign body. Suspicion of contrast medium or foreign bodies was the most common differential diagnosis. LC opacities in patients with CKD are commonly misinterpreted as foreign bodies or suspect contrast media. Conclusions: CKD patients treated with LC may have opacities throughout the digestive tract that can vary in appearance. Stopping LC treatment or changing to an alternative phosphate binder prior to planned image studies can avoid diagnostic confusion. If this is not an option, knowledge of the presentation of LC opacities is important. |
| first_indexed | 2024-03-09T22:10:32Z |
| format | Article |
| id | doaj.art-944762fdd10a41edb1584dcea2dd2818 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T22:10:32Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-944762fdd10a41edb1584dcea2dd28182023-11-23T19:32:28ZengMDPI AGDiagnostics2075-44182022-02-0112246410.3390/diagnostics12020464Lanthanum Carbonate Opacities—A Systematic ReviewJan Kampmann0Nina Pirschel Hansen1Anders Nikolai Ørsted Schultz2Andreas Hjelm Brandt3Frans Brandt4Medical Research Unit, Department of Internal Medicine, Hospital of Southern Jutland, 6200 Aabenraa, DenmarkDepartment of Radiology, Hospital of Southern Jutland, Aabenraa Branch, 6200 Aabenraa, DenmarkMedical Research Unit, Department of Internal Medicine, Hospital of Southern Jutland, 6200 Aabenraa, DenmarkDepartment of Radiology, Rigshospitalet, 2100 Copenhagen, DenmarkMedical Research Unit, Department of Internal Medicine, Hospital of Southern Jutland, 6200 Aabenraa, DenmarkBackground: Lanthanum carbonate is a phosphate binder used in advanced kidney disease. Its radiopaque appearance has been described in many case studies and case series. Misinterpretation of this phenomenon leads to unnecessary diagnostic tests and procedures. The objectives of this study were to summarize the literature on lanthanum carbonate opacities and present a visual overview. Methods: A systematic search was conducted using MEDLINE, Embase, and Web of Science. We included all types of studies, including case reports/studies, describing radiological findings of lanthanum carbonate opacities in patients with chronic kidney disease. No filter for time was set. Results: A total of 36 articles were eligible for data extraction, and 33 articles were included in the narrative synthesis. Lanthanum carbonate opacities were most commonly reported in the intestines (26 studies, 73%), stomach (8 studies, 21%), and the aerodigestive tract (2 studies, 6%). The opacities in the intestine were most frequently described as multiple, scattered radiopaque densities, compared with the aerodigestive tract, where the opacities were described as a single, round foreign body. Suspicion of contrast medium or foreign bodies was the most common differential diagnosis. LC opacities in patients with CKD are commonly misinterpreted as foreign bodies or suspect contrast media. Conclusions: CKD patients treated with LC may have opacities throughout the digestive tract that can vary in appearance. Stopping LC treatment or changing to an alternative phosphate binder prior to planned image studies can avoid diagnostic confusion. If this is not an option, knowledge of the presentation of LC opacities is important.https://www.mdpi.com/2075-4418/12/2/464lanthanum carbonateimage studiesCKD |
| spellingShingle | Jan Kampmann Nina Pirschel Hansen Anders Nikolai Ørsted Schultz Andreas Hjelm Brandt Frans Brandt Lanthanum Carbonate Opacities—A Systematic Review Diagnostics lanthanum carbonate image studies CKD |
| title | Lanthanum Carbonate Opacities—A Systematic Review |
| title_full | Lanthanum Carbonate Opacities—A Systematic Review |
| title_fullStr | Lanthanum Carbonate Opacities—A Systematic Review |
| title_full_unstemmed | Lanthanum Carbonate Opacities—A Systematic Review |
| title_short | Lanthanum Carbonate Opacities—A Systematic Review |
| title_sort | lanthanum carbonate opacities a systematic review |
| topic | lanthanum carbonate image studies CKD |
| url | https://www.mdpi.com/2075-4418/12/2/464 |
| work_keys_str_mv | AT jankampmann lanthanumcarbonateopacitiesasystematicreview AT ninapirschelhansen lanthanumcarbonateopacitiesasystematicreview AT andersnikolaiørstedschultz lanthanumcarbonateopacitiesasystematicreview AT andreashjelmbrandt lanthanumcarbonateopacitiesasystematicreview AT fransbrandt lanthanumcarbonateopacitiesasystematicreview |