title: Lanthanum-Induced Gastrointestinal Histiocytosis.
abstract: A patient with end-stage renal disease (ESRD) on hemodialysis presented with fever, anorexia, and nausea shortly after starting oral lanthanum carbonate for phosphate control. Gastric and duodenal biopsies demonstrated diffuse histiocytosis with intracellular aggregates of basophilic foreign material. Transmission electron microscopy, an underutilized diagnostic test, revealed the nature of the aggregates as heavy metal particles, consistent with lanthanum. Symptoms and histiocytosis improved after discontinuation of lanthanum. Lanthanum may be an underdiagnosed cause of gastrointestinal histiocytosis.
authors.affiliation: Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Rothenberg
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA.
authors.forename: Hiwot
authors.initials: H
authors.lastname: Araya
authors.affiliation: Department of Pathology, Stanford University School of Medicine, Stanford, CA.
authors.forename: Teri A
authors.initials: TA
authors.lastname: Longacre
authors.affiliation: Department of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Pankaj J
authors.initials: PJ
authors.lastname: Pasricha