A 55-year-old male with history of coronary artery disease, chronic kidney disease stage 4, diabetes mellitus, uncontrolled hypertension (on multiple antihypertensive medications), and iron deficiency anemia was referred for esophagogastroduodenoscopy (EGD) for evaluation of intractable nausea and vomiting. EGD showed black speckled pigmentation of the duodenal mucosa (Figure 1). Duodenal biops...

Nine patients with duodenal pseudomelanosis are described: seven had endstage renal failure while one other patient had undergone renal transplantation. Eight of the nine had been on oral iron supplements. The pigment stained positively with Perls' stain for iron in five patients, positively with the Masson-Fontana method normally used to identify melanin in one, and positively with both method...

6. Mitty RD, Wolfe GR, Cosman M. Initial description of gastric melanosis in a laxative-abusing patient. Am J Gastro. 1997;92:707--8. 7. Lin HJ, Tsay SH, Chiang H. Pseudomelanosis duodeni. Case report and review of literature. J Clin Gastroenterol. 1988;10:155--9. 8. Alberti JE, Bodor J, Torres AD. Primary malignant melanoma of the esophagus associated with melanosis of the esophagus and stomac...

Pseudomelanosis duodeni is characterized by the presence of brownish or blackish pigmentation in the duodenal mucosa identified during endoscopy. Although the pathogenesis is uncertain, it was generally believed that it is sequelae of luminal absorption of iron and sulfide chemicals, which is subsequently deposited in the lamina propria. It is often associated with hemodialysis and oral intake ...

Pseudomelanosis duodeni is a rare, benign condition of unknown etiology. It is characterized by collection of pigment-laden macrophages in the tips of duodenal villi. The pigment, originally interpreted as melanin, pseudomelanin, lipomelanin or hemosiderin, has now been demonstrated to be mostly ferrous sulfide. There is a strong association with chronic renal failure, arterial hypertension, di...

6. Mitty RD, Wolfe GR, Cosman M. Initial description of gastric melanosis in a laxative-abusing patient. Am J Gastro. 1997;92:707--8. 7. Lin HJ, Tsay SH, Chiang H. Pseudomelanosis duodeni. Case report and review of literature. J Clin Gastroenterol. 1988;10:155--9. 8. Alberti JE, Bodor J, Torres AD. Primary malignant melanoma of the esophagus associated with melanosis of the esophagus and stomac...