Duodenal Pseudomelanosis: A Literature Review

Duodenal pseudomelanosis (also known as pseudomelanosis duodeni) is a rare endoscopic incidental finding defined by a pigmentation limited to the apex of the intestinal villi, which requires histological confirmation. While its exact pathogenesis is still poorly understood, it appears free from clin...

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Bibliographic Details
Published in:Diagnostics (Basel) 2021-10, Vol.11 (11), p.1974
Main Authors: Lopez, Gianluca, D’Ercole, Marianna, Ferrero, Stefano, Croci, Giorgio Alberto
Format: Article
Language:English
Subjects:
Biopsy
Diabetes
Drugs
duodenal
duodenum
Editing
Endoscopy
Hypertension
Iron
Kidney diseases
Laxatives
Melanoma
Metastasis
Pathogenesis
pigmentation
pseudomelanosis
Review
siderosis
Stains & staining
Sulfur
Writing
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Summary:Duodenal pseudomelanosis (also known as pseudomelanosis duodeni) is a rare endoscopic incidental finding defined by a pigmentation limited to the apex of the intestinal villi, which requires histological confirmation. While its exact pathogenesis is still poorly understood, it appears free from clinical consequences. This condition is believed to be associated with oral iron intake, antihypertensive drugs containing a sulfur moiety (i.e., hydralazine, furosemide), and several chronic diseases (i.e., hypertension, end-stage renal disease, diabetes). However, the exact prevalence of these treatments and comorbidities among patients with duodenal pseudomelanosis is not clearly defined. Several case reports and case series about duodenal pseudomelanosis have been published in recent years. In this review, we aimed to clearly define its endoscopic and microscopic presentation; its epidemiology, associated comorbidities, and drugs; the most useful special histochemical techniques used to classify the nature of the pigmentation; and the most relevant differential diagnoses. In addition, by considering our findings, we also formulated a number of hypotheses about its pathogenesis.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics11111974