Melanosis duodeni

Bisordi, William M.; Kleinman, Martin S.

doi:10.1016/s0016-5107(76)73576-4

Cited by 51 publications

(31 citation statements)

References 2 publications

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“…Although aluminum and silicon-containing compounds are common and may be detected as food additives or in medicines, hemosiderin pigment has also been detected in the ileum and hypothesized to result from intermittent bleeding within the upper gastrointestinal tract. Similarly, melanosis duodeni has also been related to occasional bleeding, usually from peptic ulceration [7][8][9][10] . …”

Section: Melanosis Of Small Intestinementioning

confidence: 99%

“Melanosis” in the small and large intestine

Freeman

2008

WJG

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Deposition of pigment in the intestinal mucosa is commonly observed by the endoscopist, especially within the colon, and particularly during investigations for constipation. Pigment may also be detected in the small intestine. Although labeled as melanosis, electron microscopy and X-ray analytical methods have provided evidence that this pigment is not melanin at all, but lipofuscin. Often, herbal remedies or anthracene containing laxatives are often historically implicated, and experimental studies in both humans and animal models have also confirmed the intimate relationship with these pharmacological or pseudo-pharmacological remedies. The appearance of melanosis coli during colonoscopy is largely due to pigment granule deposition in macrophages located in the colonic mucosa. The pigment intensity is not uniform, being more intense in the cecum and proximal colon compared to the distal colon. Possibly, this reflects higher luminal concentrations of an offending agent in the proximal compared to distal colon, differential absorption along the length of the colon, or finally, differences in macrophage distribution within the colon. Mucosal lymphoid aggregates normally display a distinct absence of pigment producing a "starry sky" appearance, especially in the rectosigmoid region. Interestingly, some focal, usually sessile, colonic mucosal neoplastic lesions, rather than submucosal lesions, may be better appreciated as pigment deposition may be absent or limited. If detected, removal and further histopathologic analysis of the polyp may be facilitated.

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Section: Melanosis Of Small Intestinementioning

confidence: 99%

“Melanosis” in the small and large intestine

Freeman

2008

WJG

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“…Pseudomelanosis of the duodenum, first described in 1976, refers to the endoscopic visualization of speckled dark pigmentation of the mucosa 1. Histologic analysis reveals a granular pigment in the macrophage lysosomes in the lamina propria around the tips of the duodenal villi.…”

Section: Discussionmentioning

confidence: 99%

“…Pseudomelanosis of the upper gastrointestinal (GI) tract is an uncommon entity characterized by endoscopic visualization of speckled dark pigmentation of the mucosa 1. It should be noted that while ‘melanosis’ has been described previously in the gastrointestinal tract in colon and rectum, duodenal pseudomelanosis is rare with gastric pseudomelanosis being exceedingly rare with only few reported cases 2,3.…”

Section: Introductionmentioning

confidence: 99%

Peppered and rare – Gastric and Duodenal Pseudomelanosis: A case series

Samiullah¹,

Bhurgri²,

Babar³

et al. 2017

Pak J Med Sci

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Upper Gastrointestinal (GI) pseudomelanosis is an uncommon entity characterized by endoscopic visualization of speckled dark mucosal pigmentation. While described in the rectum and colon, ‘melanosis’ or more aptly ‘pseudomelanosis’ is rare in the duodenum and exceedingly rare in the stomach. Five cases of pseudomelanosis were encountered at our department. Four females and one male were diagnosed, with a mean age of 70 years. All patients exhibited duodenal pseudomelanosis, with one demonstrating gastric antral pseudomelanosis as well. Common features among these patients included iron deficiency anemia, hypertension, chronic kidney disease, hydralazine use and iron supplementation. Biopsy specimens stained at least partially positive for iron and stains for calcium and copper were negative. Histochemical analysis revealed the pigment of pseudomelanosis to be mainly iron sulfide, exhibiting unpredictable staining patterns, hypothesized to be secondary to varying sulfur content and iron oxidation. It is visualized as dark deposits in macrophages at the tips of the duodenal villi. Upper GI pseudomelanosis remains a poorly understood finding, weakly associated with chronic kidney disease, diabetes, hypertension, iron supplements and anti-hypertensive medications. While the pathogenesis, clinical and prognostic significance remains unclear, it is thus far considered a benign condition.

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“…It appears to be more common in women in the sixth to seventh decades of life and has distinctive endoscopic, histopathological and electron microscopic features 1. First described in 1976, it was initially thought to be a form of stored iron 2 . Pseudomelanosis duodeni has also been described in patients with hypertension, chronic renal failure, chronic heart failure and diabetes mellitus 1 3–5…”

Section: Discussionmentioning

confidence: 99%

Pseudomelanosis duodeni in a postrenal transplant patient

2013

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SUMMARYPseudomelanosis duodeni is a rare entity characterised by dark pigmented intracellular granules seen within macrophages that lie within the lamina propria of the duodenal villi. There is no known treatment, and the clinical significance and long-term sequelae of this entity are unclear. We present a case of pseudomelanosis duodeni in a 54-year-old woman who presented with a 1-month history of nausea, vomiting and non-bloody diarrhoea. The medical history was significant for diabetes mellitus type 2, end-stage renal disease status postkidney transplant, hypertension, anaemia of chronic disease and hypothyroidism. A gastroduodenal endoscopy revealed pigmented dark lesions in the duodenal mucosa. Biopsies from the second part of the duodenum and duodenal bulb showed pigmented macrophages in the lamina propria. The findings were consistent with duodenal melanosis. In spite of renal transplant with normalisation of renal function, the duodenal melanosis persists, which raises questions on the role of renal impairment in this entity. BACKGROUND

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Melanosis duodeni

Cited by 51 publications

References 2 publications

“Melanosis” in the small and large intestine

“Melanosis” in the small and large intestine

Peppered and rare – Gastric and Duodenal Pseudomelanosis: A case series

Pseudomelanosis duodeni in a postrenal transplant patient

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