title: Pseudomelanosis duodeni associated with chronic renal failure.
abstract: Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding, hypertension, chronic heart failure, chronic renal failure and consumption of different drugs. We report four cases of PD associated with chronic renal failure admitted to the gastroenterology outpatient unit due to epigastric pain, nausea, melena and progressive reduction of hemoglobin index. Gastroduodenal endoscopy revealed erosions in the esophagus and stomach, with no active bleeding at the moment. In addition, the duodenal mucosa presented marked signs of melanosis; later confirmed by histopathological study. Even though PD is usually regarded as a benign condition, its pathogenesis and clinical significance is yet to be defined.
authors.affiliation: Gastroenterology Section, Department of Internal Medicine, Clementino Fraga Filho University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
authors.forename: Marcia Henriques
authors.initials: MH
authors.lastname: de Magalhães Costa
authors.forename: Maria da Gloria
authors.initials: Mda G
authors.lastname: Fernandes Pegado
authors.forename: Cleber
authors.initials: C
authors.lastname: Vargas
authors.forename: Maria Elizabeth C
authors.initials: ME
authors.lastname: Castro
authors.forename: Kalil
authors.initials: K
authors.lastname: Madi
authors.forename: Tiago
authors.initials: T
authors.lastname: Nunes
authors.forename: Cyrla
authors.initials: C
authors.lastname: Zaltman
mesh_terms: D000328:Adult; D000368:Aged; D004378:Duodenal Diseases / Q000209:etiology* / Q000473:pathology*; D004386:Duodenum / Q000473:pathology*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000473:pathology*; D008543:Melanins / Q000378:metabolism*
chemical_list: D008543:Melanins