Schuerle Theresa, Aoun Elie, Clarke Kofi
West Penn Allegheny Health System, Pittsburgh, Pennsylvania, USA.
BMJ Case Rep. 2013 Dec 10;2013:bcr2013200466. doi: 10.1136/bcr-2013-200466.
Pseudomelanosis duodeni is a rare entity characterised by dark pigmented intracellular granules seen within macrophages that lie within the lamina propria of the duodenal villi. There is no known treatment, and the clinical significance and long-term sequelae of this entity are unclear. We present a case of pseudomelanosis duodeni in a 54-year-old woman who presented with a 1-month history of nausea, vomiting and non-bloody diarrhoea. The medical history was significant for diabetes mellitus type 2, end-stage renal disease status postkidney transplant, hypertension, anaemia of chronic disease and hypothyroidism. A gastroduodenal endoscopy revealed pigmented dark lesions in the duodenal mucosa. Biopsies from the second part of the duodenum and duodenal bulb showed pigmented macrophages in the lamina propria. The findings were consistent with duodenal melanosis. In spite of renal transplant with normalisation of renal function, the duodenal melanosis persists, which raises questions on the role of renal impairment in this entity.
十二指肠假黑色素沉着症是一种罕见病症，其特征是在十二指肠绒毛固有层内的巨噬细胞中可见深色的细胞内色素颗粒。目前尚无已知的治疗方法，该病症的临床意义和长期后果尚不清楚。我们报告一例54岁女性的十二指肠假黑色素沉着症病例，该患者有1个月的恶心、呕吐和非血性腹泻病史。病史显示患者患有2型糖尿病、肾移植术后终末期肾病、高血压、慢性病贫血和甲状腺功能减退。胃十二指肠内镜检查发现十二指肠黏膜有色素沉着的深色病变。十二指肠第二部和十二指肠球部的活检显示固有层有色素沉着的巨噬细胞。这些发现与十二指肠黑色素沉着症相符。尽管进行了肾移植且肾功能恢复正常，但十二指肠黑色素沉着症仍然存在，这引发了关于肾功能损害在该病症中作用的疑问。
