Kang J Y, Wu A Y, Chia J L, Wee A, Sutherland I H, Hori R
Department of Medicine, National University of Singapore.
Gut. 1987 Dec;28(12):1673-81. doi: 10.1136/gut.28.12.1673.
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 methods in three. Electron probe x-ray analysis of the pigment on samples from six patients showed iron to be present in all six, while sulphur was present in five. Varying sulphur content of the pigment in different patients could account for differences in histochemical characteristics. Iron was also shown in the duodenal biopsies of 34 of 48 uraemic patients on oral iron supplements, but was present in only 22 of 120 patients endoscoped for miscellaneous conditions (p less than 0.001). We postulate that the pigment of duodenal pseudomelanosis is derived from iron absorbed from the lumen.
本文描述了9例十二指肠假性黑变病患者：其中7例为终末期肾衰竭患者，1例为肾移植患者。9例患者中有8例曾服用口服铁剂。9例患者中，5例的色素用Perls铁染色呈阳性，1例用通常用于鉴定黑色素的Masson-Fontana法染色呈阳性，3例两种方法染色均呈阳性。对6例患者样本中的色素进行电子探针X射线分析显示，所有6例均存在铁，5例存在硫。不同患者色素中硫含量的差异可解释组织化学特征的差异。在48例接受口服铁剂治疗的尿毒症患者中，34例十二指肠活检也显示有铁，但在120例因各种疾病接受内镜检查的患者中，只有22例有铁（P<0.001）。我们推测十二指肠假性黑变病的色素来源于从肠腔吸收的铁。
