title: Small bowel pseudomelanosis and oral iron therapy.
abstract: Small bowel pseudomelanosis is a rarely reported clinical entity characterized by brown pigmentation of small bowel mucosa. The authors describe two cases, both with iron deficiency anemia, one of an 81-year-old female patient submitted for capsule endoscopy that revealed a brown pigmentation of all small bowel mucosa and another of an 81-year-old male whose retrograde double-balloon enteroscopy revealed a diffuse brown pattern of small bowel mucosa. Ileal biopsies confirmed intense iron deposition in the macrophages of the lamina propria. Both patients were on oral iron therapy and the second one had a previous double-balloon enteroscopy, 2 years earlier, which revealed only ileal angiodysplasias. These two cases demonstrate the importance of two new endoscopic methods for diagnosis of small bowel pseudomelanosis, the rarity of such an entity and its close relation with oral iron therapy.
authors.affiliation: Department of Gastroenterology, Coimbra University Hospital, Coimbra, Portugal. nunoperesalmeida@gmail.com
authors.forename: Nuno
authors.initials: N
authors.lastname: Almeida
authors.forename: Pedro
authors.initials: P
authors.lastname: Figueiredo
authors.forename: Sandra
authors.initials: S
authors.lastname: Lopes
authors.forename: Paulo
authors.initials: P
authors.lastname: Freire
authors.forename: Vítor
authors.initials: V
authors.lastname: Sousa
authors.forename: Clotilde
authors.initials: C
authors.lastname: Lérias
authors.forename: Hermano
authors.initials: H
authors.lastname: Gouveia
authors.forename: Maximino C
authors.initials: MC
authors.lastname: Leitão
mesh_terms: D000284:Administration, Oral; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy*; D053704:Capsule Endoscopy; D016145:Endoscopy, Digestive System; D005260:Female; D006397:Hematinics / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced*; D007410:Intestinal Diseases / Q000139:chemically induced*; D007421:Intestine, Small; D007501:Iron / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male
chemical_list: D006397:Hematinics; D007501:Iron