An Interesting Case of Pseudomelanosis Duodeni with Brunner’s Gland Hyperplasia

Pseudomelanosis (PM) is a rare disorder characterized by scattered black pigmentation of the intestinal mucosa. PM has uncertain etiology and pathogenesis. It has been linked to several drugs and systemic illnesses. Upper gastrointestinal (GI) pseudomelanosis is an uncommon condition that may be brought on by oral iron consumption, upper GI hemorrhage, end-stage renal failure, or antihypertensive drug use. The duodenal involvement is well described in literature. The lesion is passive but can mimic more alarming entities like malignant melanoma. We describe a 33-year-old woman who had nonspecific dyspepsia, thrombocytopenia, systemic lupus erythematosus, chronic kidney disease, hypertension, and arthritis. Upper GI endoscopy revealed patches of speckled black spots in the duodenum, which were identified as duodenal pseudomelanosis.