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Case Reports
. 2012 Mar 28;18(12):1414-6.
doi: 10.3748/wjg.v18.i12.1414.

Pseudomelanosis duodeni associated with chronic renal failure

Marcia Henriques de Magalhães Costa  1 , Maria da Gloria Fernandes Pegado, Cleber Vargas, Maria Elizabeth C Castro, Kalil Madi, Tiago Nunes, Cyrla Zaltman
Affiliations
Case Reports

Pseudomelanosis duodeni associated with chronic renal failure

Marcia Henriques de Magalhães Costa et al. World J Gastroenterol. .

Abstract

Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding, hypertension, chronic heart failure, chronic renal failure and consumption of different drugs. We report four cases of PD associated with chronic renal failure admitted to the gastroenterology outpatient unit due to epigastric pain, nausea, melena and progressive reduction of hemoglobin index. Gastroduodenal endoscopy revealed erosions in the esophagus and stomach, with no active bleeding at the moment. In addition, the duodenal mucosa presented marked signs of melanosis; later confirmed by histopathological study. Even though PD is usually regarded as a benign condition, its pathogenesis and clinical significance is yet to be defined.

Keywords: Anti hypertensive drugs; Chronic renal failure; Diabetes mellitus; Gastroduodenal endoscopy; Pseudomelanosis duodeni.

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Figures

Figure 1
Figure 1
Endoscopic picture showing multiple dark brown spots in the duodenum.
Figure 2
Figure 2
Many macrophages containing brown pigmented granules within the lamina propria (hematoxylin and eosin stain, x 200).
Figure 3
Figure 3
Iron deposits inside macrophage cytoplasm (Masson-Fontana stain, x 200).
See this image and copyright information in PMC

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