IMAGES IN MEDICINE
An unusual abdominal radiograph
Department of Renal Medicine, Dorset County Hospital, Dorchester, UK
Correspondence to:
Dr A Connor, Department of Renal Medicine, Dorset County Hospital, Williams Avenue, Dorchester, DT1 2JY, UK; andrewconnor1974@hotmail.co.uk
Accepted 29 October 2008
| The first 150 words of the full text of this article appear below. |
A 50-year-old man receiving haemodialysis for end stage renal disease was investigated for abdominal pain. Chronic pancreatitis was considered and a plain abdominal radiograph was requested. Unexpectedly, this showed diffuse radio-opaque material throughout the colon (fig 1). A review of his medications revealed that he was taking lanthanum carbonate.
Figure 1 Plain abdominal radiograph showing radio-opaque material throughout the colon.
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Lanthanum carbonate is a novel agent that is increasingly commonly prescribed to control the hyperphosphataemia of secondary hyperparathyroidism in patients with end stage renal disease.1 It dissociates in the stomach to the lanthanum ion which binds phosphate before excretion in the faeces. Lanthanum is a rare-earth element with a density approaching that of metal. Clinicians of all backgrounds should be aware of the distinctive radiological appearances seen in patients taking lanthanum carbonate. When possible, alternative phosphate binders should be temporarily employed before radiological examinations.
Competing interests: None.
Patient consent: Obtained
- Persy VP, Behets GJ, Bervoets AR, et al.. Lanthanum: a safe phosphate binder. Semin Dial 2006;19:195–9.[CrossRef][Medline]
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