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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Lanthanum phosphate binder-induced iron deficiency anaemia
  1. Christina Awad1,
  2. Karin Gilkison2 and
  3. Erwin Shaw2
  1. 1 Internal Medicine, US Air Force Hospital Lackland AFB, San Antonio, Texas, USA
  2. 2 US Air Force Hospital Keesler AFB, Keesler AFB, Mississippi, USA
  1. Correspondence to Dr Christina Awad, cnawad18{at}gmail.com

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.

  • gastrointestinal system
  • Gi bleeding
  • drugs: gastrointestinal system
  • ulcer
  • oesophagus

https://doi.org/10.1136/bcr-2018-226157

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    Footnotes

    • Contributors CA performed all the background research, studied the patient’s case, endoscopic and pathology findings. KG is the expert on the case. She is the gastroenterologist who follows the patient. She provided CA with all the necessary documents for the case. She reviewed the case report and provided feedback. ES is the pathologist who reviewed the patient’s slides and commented on the findings as stated in the case report.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.