Related Experiment Videos
Case reports: pseudomelanosis duodeni: association with systemic hypertension
H M eL-Newihi1, C A Lynch, A A Mihas
1Division of Gastroenterology, Veterans Affairs Medical Center, Jackson, MS 39216, USA.
The American Journal of the Medical Sciences
|September 1, 1995
Summary
Hypertension may cause dark duodenal pigmentation in patients, even children. This melanin-like pigment, found in macrophages, contains iron, sulfur, and calcium, persisting long after other symptoms resolve.
Area of Science:
- Gastroenterology
- Pathology
- Toxicology
Background:
- Gastrointestinal bleeding is a common clinical presentation.
- Endoscopic examination is crucial for diagnosing upper gastrointestinal pathologies.
- Systemic hypertension is a prevalent comorbidity in various patient populations.
Observation:
- Peculiar dark pigmentation of the duodenum was observed in two male patients with mild gastrointestinal bleeding.
- These pigmented lesions persisted for at least 3 months post-endoscopy, independent of other resolving mucosal lesions.
- Both patients had a history of long-term antihypertensive medication use due to systemic hypertension.
Findings:
- Biopsies revealed pigment within macrophages in the lamina propria and between epithelial cells of the duodenal lesions.
- Electron microscopy confirmed lysosomal localization of the melanin-like pigment.
- The pigment was found to contain iron, sulfur, and calcium, and its presence was associated with systemic hypertension, including in pediatric cases.
Implications:
- This finding suggests a potential link between antihypertensive medications, systemic hypertension, and duodenal pigmentation.
- Further research is warranted to elucidate the exact mechanism and clinical significance of this pigment.
- Consideration of duodenal pigmentation in hypertensive patients may aid in diagnosis and management.