PSEUDOMELANOSIS DUODENI - ASSOCIATION WITH SYSTEMIC HYPERTENSION

Two male patients with mild gastrointestinal bleeding had peculiar dar k pigmentation of their duodenum on upper endoscopy, These pigmented l esions were still present 3 months after the original endoscopy and af ter resolution of all other mucosal lesions, Both patients had other m edical problems, including hypertension. They have been on multiple an tihypertensive medications for many years, Biopsies of these duodenal lesions showed the pigment to be present inside the macrophages found in the lamina propria and in between the epithelial cells, Electron mi croscopy revealed a lysosomal localization of this pigment, This melan in-like pigment proved to contain varying amounts of iron, sulfur, and calcium, This pigmentation is closely associated with systemic hypert ension, even in the pediatric population.