Brown Bowel Syndrome Associated with Vitamin E Deficiency and Malabsorption (Intestinal Lipofuscinosis)

 

Synonym: intestinal lipofuscinosis

 

Pathophysiology: mitochondrial myopathy secondary to vitamin E deficiency that affects smooth muscle cells

 

Features:

(1) brown coloration to the intestines (in less severe cases may be "darker than normal")

(2) presence of malabsorption

(3) presence bowel dilatation due to hypotonia and/or atonia (poor contractility)

(4) presence of a large amount of brown lipofuscin pigment in the smooth muscle layers of the bowel wall and blood vessels

(5) vitamin E deficiency that is usually mixed with other nutritional deficiencies (moderate to severe malnutrition)

 

Correction of the vitamin E and nutritional deficiencies may result in partial but often not complete correction of the problem.

 

Differential diagnosis:

(1) melanosis coli (pigment is within macrophages in the lamina propria)