Transient Adhesion of Lanthanum Carbonate OD Tablet to the Esophagus; A Suspected Case in a Hemodialysis Patient

Abstract

We report a suspected case of transient remaining of lanthanum carbonate OD tablet at middle the esophagus in patient with hemodialysis. The patient was 70s woman with 28 years dialysis vintage. After she came to our dialysis clinic, she had a lunch then took two calcium carbonate OD tablets (Caltan® OD 500mg tablet) and one lanthanum carbonate OD tablet (Fosrenol® OD 250mg tablet). The day was a scheduled day of chest X-ray examination prior to hemodialysis. In the X-ray image, a tablet-like circular shade was identified in middle the esophagus. Physician confirmed that there were no foreign objects on the patient’s clothing or skin and another X-ray radiograph was taken. The following images revealed that the shade was gradually disintegrating. The physician instructed her to drink additional water and to hold in sitting position for 10 minutes, then another X-ray was taken. In the final image, the shade was completely disappeared. In this case, the shade that existed in the esophagus was considered to be a lanthanum carbonate OD tablet. To avoid sticking OD tablet to esophagus, if taken without disintegration in oral cavity, it is necessary to require at least same amount of water to drink as taking regular tablets was suggested.