Clinical Gastroenterology Vol.15 No.9(1)

Theme Digestive Diseases to Know --Duodenum
Title Melanosis Duodeni
Publish Date 2000/08
Author Kazuya Makiyama Department of Endoscopy, Nagasaki University School of Medicine
Author Tomayoshi Hayashi Department of Pathology, Nagasaki University School of Medicine
[ Summary ] Melanosis duodeni is a very rare and reversible condition, characterized by speckled black pigmentation (a pepper sprinkled appearance) as seen with endoscopy of the duodenal mucosa. This pigment corre sponds principally to a accumulation of ferrous sulfide and calcium inside the lysosomes of macrophages, located in the lamina propria. This condition occurs predominantly in elderly female patients and is strongly linked to chronic illnesses, including systemic hypertension, chronic renal failure, upper gastrointestinal bleeding and diabetes mellitus and is related to use of some common medications, including hydralazine, propranolol, thiazide diuretics, furosemide and ferrous sulfate. From an etiological point of view, it is suggested that in cases of melanosis duodeni, iron metabolism may be impaired and iron may pool within the macrophages. However, this etiology and its detailed clinical significance remain obscure.
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