Cronkhite-Canada Syndrome Successfully Treated by Corticosteroids before Presenting Typical Ectodermal Symptoms

Cronkhite-Canada syndrome (CCS) is a rare disease characterized by diffuse gastrointestinal polyposis with chronic diarrhea and ectodermal change, but its etiology is unknown. We present a case at the age of 26 years complaining of epigastralgia and weight loss. Endoscopic examination revealed exten...

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Published inCase Reports in Gastroenterology Vol. 14; no. 3; pp. 561 - 569
Main Authors Murata, Kazumoto, Sato, Kiichi, Okada, Shinya, Suto, Daisuke, Otake, Takaaki, Kohgo, Yutaka
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 01.09.2020
Karger Publishers
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ISSN1662-0631
1662-0631
DOI10.1159/000510920

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Abstract Cronkhite-Canada syndrome (CCS) is a rare disease characterized by diffuse gastrointestinal polyposis with chronic diarrhea and ectodermal change, but its etiology is unknown. We present a case at the age of 26 years complaining of epigastralgia and weight loss. Endoscopic examination revealed extensive diffuse polypoid lesions of the stomach and the terminal ileum, all of which showed hyperplastic polyps pathologically. There were no polypoid lesions in his colon. He has no family history of diffuse gastrointestinal polyposis. Diffuse gastrointestinal hyperplastic polyposis without any hereditary association led us to suspect this case as CCS although he did not show chronic diarrhea and any ectodermal symptoms such as onychodystrophy, alopecia, and hyperpigmentation. After initiation of a corticosteroid therapy, his epigastralgia disappeared and he gained appetite and weight, accompanied by normalization of serum albumin levels. Endoscopic examination 1 year after initiation of corticosteroid therapy revealed a decrease in the number of gastric polyposis and those inflammations. This rare young case may suggest that early therapeutic intervention with corticosteroids could improve the prognosis of CCS, preventing not only malnutrition but also appearance of several ectodermal symptoms.
AbstractList Cronkhite-Canada syndrome (CCS) is a rare disease characterized by diffuse gastrointestinal polyposis with chronic diarrhea and ectodermal change, but its etiology is unknown. We present a case at the age of 26 years complaining of epigastralgia and weight loss. Endoscopic examination revealed extensive diffuse polypoid lesions of the stomach and the terminal ileum, all of which showed hyperplastic polyps pathologically. There were no polypoid lesions in his colon. He has no family history of diffuse gastrointestinal polyposis. Diffuse gastrointestinal hyperplastic polyposis without any hereditary association led us to suspect this case as CCS although he did not show chronic diarrhea and any ectodermal symptoms such as onychodystrophy, alopecia, and hyperpigmentation. After initiation of a corticosteroid therapy, his epigastralgia disappeared and he gained appetite and weight, accompanied by normalization of serum albumin levels. Endoscopic examination 1 year after initiation of corticosteroid therapy revealed a decrease in the number of gastric polyposis and those inflammations. This rare young case may suggest that early therapeutic intervention with corticosteroids could improve the prognosis of CCS, preventing not only malnutrition but also appearance of several ectodermal symptoms.
Cronkhite-Canada syndrome (CCS) is a rare disease characterized by diffuse gastrointestinal polyposis with chronic diarrhea and ectodermal change, but its etiology is unknown. We present a case at the age of 26 years complaining of epigastralgia and weight loss. Endoscopic examination revealed extensive diffuse polypoid lesions of the stomach and the terminal ileum, all of which showed hyperplastic polyps pathologically. There were no polypoid lesions in his colon. He has no family history of diffuse gastrointestinal polyposis. Diffuse gastrointestinal hyperplastic polyposis without any hereditary association led us to suspect this case as CCS although he did not show chronic diarrhea and any ectodermal symptoms such as onychodystrophy, alopecia, and hyperpigmentation. After initiation of a corticosteroid therapy, his epigastralgia disappeared and he gained appetite and weight, accompanied by normalization of serum albumin levels. Endoscopic examination 1 year after initiation of corticosteroid therapy revealed a decrease in the number of gastric polyposis and those inflammations. This rare young case may suggest that early therapeutic intervention with corticosteroids could improve the prognosis of CCS, preventing not only malnutrition but also appearance of several ectodermal symptoms.Cronkhite-Canada syndrome (CCS) is a rare disease characterized by diffuse gastrointestinal polyposis with chronic diarrhea and ectodermal change, but its etiology is unknown. We present a case at the age of 26 years complaining of epigastralgia and weight loss. Endoscopic examination revealed extensive diffuse polypoid lesions of the stomach and the terminal ileum, all of which showed hyperplastic polyps pathologically. There were no polypoid lesions in his colon. He has no family history of diffuse gastrointestinal polyposis. Diffuse gastrointestinal hyperplastic polyposis without any hereditary association led us to suspect this case as CCS although he did not show chronic diarrhea and any ectodermal symptoms such as onychodystrophy, alopecia, and hyperpigmentation. After initiation of a corticosteroid therapy, his epigastralgia disappeared and he gained appetite and weight, accompanied by normalization of serum albumin levels. Endoscopic examination 1 year after initiation of corticosteroid therapy revealed a decrease in the number of gastric polyposis and those inflammations. This rare young case may suggest that early therapeutic intervention with corticosteroids could improve the prognosis of CCS, preventing not only malnutrition but also appearance of several ectodermal symptoms.
Author Otake, Takaaki
Murata, Kazumoto
Kohgo, Yutaka
Sato, Kiichi
Okada, Shinya
Suto, Daisuke
AuthorAffiliation 2 Department of Gastroenterology, International University of Health and Welfare, Nasushiobara, Japan
3 Department of Pathology, International University of Health and Welfare, Nasushiobara, Japan
1 Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
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Cites_doi 10.1056/NEJM195506162522401
10.1046/j.1365-2036.2002.01172.x
10.3748/wjg.v20.i23.7518
10.1007/s00535-015-1107-7
10.1016/S0016-5085(19)33360-8
10.1155/2016/4210397
10.1186/s12876-016-0541-1
10.14740/gr912w
10.1016/j.suc.2008.05.002
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Keywords Remission
Cronkhite-Canada syndrome
Nonhereditary polyposis
Corticosteroids
Language English
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– reference: Johnson GK, Soergel KH, Hensley GT, Dodds WJ, Hogan WJ. Cronkite-Canada syndrome: gastrointestinal pathophysiology and morphology. Gastroenterology. 1972Jul;63(1):140–52. 10.1016/S0016-5085(19)33360-850557380016-5085
– reference: Cronkhite LWJr, CanadaWJ. Generalized gastrointestinal polyposis; an unusual syndrome of polyposis, pigmentation, alopecia and onychotrophia. N Engl J Med. 1955Jun;252(24):1011–5. 10.1056/NEJM195506162522401143839520028-4793
– reference: Faria MA, Basaglia B, Nogueira VQ, de Mendonca TB, Kaiser Junior RL, Filho IJ, et al.. A case of adolescent Cronkhite-Canada syndrome. Gastroenterol Res. 2018Feb;11(1):64–7. 10.14740/gr912w295114101918-2805
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– reference: Ward EM, Wolfsen HC. Review article: the non-inherited gastrointestinal polyposis syndromes. Aliment Pharmacol Ther. 2002Mar;16(3):333–42. 10.1046/j.1365-2036.2002.01172.x118766850269-2813
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SubjectTerms Abdomen
Alopecia
Baldness
Case reports
Colon
Colonoscopy
corticosteroids
cronkhite-canada syndrome
Diarrhea
Diseases of the digestive system. Gastroenterology
Endoscopy
Esophagus
Immunomodulators
Malnutrition
nonhereditary polyposis
Pathology
Patients
Protein synthesis
Proteins
Rare diseases
RC799-869
remission
Remission (Medicine)
Single Case
Small intestine
Steroids
Stomach
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Title Cronkhite-Canada Syndrome Successfully Treated by Corticosteroids before Presenting Typical Ectodermal Symptoms
URI https://karger.com/doi/10.1159/000510920
https://cir.nii.ac.jp/crid/1874242817992598016
https://www.proquest.com/docview/2570020656
https://www.proquest.com/docview/2465759880
https://pubmed.ncbi.nlm.nih.gov/PMC7670349
https://doaj.org/article/60bd55fcbab34820a9d97c9117b49f46
Volume 14
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