alexa Gastric and Duodenal Pseudomelanosis in a Patient with Anaemia | Open Access Journals
ISSN: 2475-3181
Journal of Hepatology and Gastrointestinal disorders
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Gastric and Duodenal Pseudomelanosis in a Patient with Anaemia

Marcelo Campos Appel-da-Silva1*, Rafael Bergesch D’Incao1, Eduardo Marques Corrêa1, Bruno Galperim1 and Mariana Guimarães Coelho2

1Department of Gastroenterology and Endoscopy, Hospital Mãe de Deus, Porto Alegre, Brazil

2Department of Pathology, Hospital Mãe de Deus, Porto Alegre, Brazil

*Corresponding Author:
Marcelo Campos Appel-da-Silva
Rua Jose de Alencar, 286 Porto Alegre
RS 90880-480, Brazil
Tel: +5551991134418
E-mail: marceloappel@yahoo.com.br

Received date: May 31, 2017; Accepted date: June 02, 2017; Published date: June 06, 2017

Citation: Appel-da-Silva MC, D’Incao RB, Corrêa EM, Galperim B, Coelho MG (2017) Gastric and Duodenal Pseudomelanosis in a Patient with Anaemia. J Hepatol Gastroint Dis 3:i105. doi: 10.4172/2475-3181.1000i105

Copyright: © 2017 Appel-da-Silva MC, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Clinical Image

An 87-year-old man with diabetes mellitus, hypertension, past history of colonic cancer and a current treatment for prostate cancer was admitted to the Oncology Ward for evaluation of iron-deficiency anaemia. He was taking gosereline, zoledronic acid and dexametasone. An upper gastrointestinal endoscopy was performed and revealed a mucosal abnormality characterized by discoloration of the posterior wall of part of his gastric corpus, antrum and over the duodenum (Figure 1). No ulcers, erosions, or any other causes for bleeding were identified. Histopathology report confirmed the presence of loose aggregates of macrophages containing a granular black pigment within the superficial lamina própria, which tested positive for iron at Perl’s stain (Figure 2). Helicobacter pylori organism was absent. Patient informed recent use of ferrous sulfate.

hepatology-gastrointestinal-posterior-wall

Figure 1: Discoloration of the posterior wall of part of his gastric corpus, antrum and over the duodenum.

hepatology-gastrointestinal-Loose-aggregates

Figure 2: Loose aggregates of macrophages containing a granular black pigment within the superficial lamina própria.

Pseudomelanosis of the gastrointestinal tract is a rare endoscopic mucosal finding, characterized, endoscopically as discrete, flat, small, black spots in a speckled pattern on a flat mucosa, representing the accumulation of iron in macrophages of the lamina propria of the stomach and duodenum.

The clinical significance and long term sequelae have not been clarified yet. However, this benign condition is associated with a variety of clinical conditions, such as chronic renal disease, hypertension, diabetes mellitus, oral iron supplementation, antihypertensive medications.

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