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[A patient with chronic diarrhoe, head pigmentation and alopecia. Cronkhite-Canada syndrome].
Dtsch Med Wochenschr. 2010 Feb; 135(8):339-42.DM

Abstract

HISTORY AND FINDINGS ON ADMISSION

A 70-year-old man with a 14 month history of chronic severe diarrhea treated with budenosid and mesalazin was admitted because of peripheral oedema and weight loss of about 26 kg.

INVESTIGATIONS AND DIAGNOSIS

A general pigmentation of the skin, especially on scull and hands, as well as dystrophic nail changes and alopecia of scalp and facial hair were seen. The tests showed a slight macrocytotic, normochromic anemia. Total protein and the clotting factors were decreased. Endoscopy revealed multiple sessile polyps in the stomach and duodenum in appearance to colon and rectum. Endoscopic removal of a polyp showed histologically cystic dilatation of foveolae and oedematous mucosa. The histological features, the wide distribution of the polyps together with the skin changes, lead to the diagnosis of Cronkhite-Canada syndrome (CCS).

TREATMENT AND COURSE

The patient was initially treated with prednisolon 60 mg/d i. v. for 2 weeks, resulting in a marked improvement of symptoms and weight gain. He is at present in good health under prednisolon 20 mg/d per os and is followed up in our outpatient department.

CONCLUSION

CCS is in up to 14 % of the cases associated with a carcinoma of the gastrointestinal tract. At present there are only reports about a successful treatment by steroids, prophylactic gastrectomy and proctocolectomy. Typical myopathic lesions of CCS have not been described to date, but the demonstrated improvement of creatinin kinase with successful treatment suggests a common pathophysiological mechanism.

Authors+Show Affiliations

Medizinische Abteilung II, Universitätsklinikum Albert-Ludwigs-Universität Freiburg i. Br.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

ger

PubMed ID

20165997

Citation

Fischer, R, et al. "[A Patient With Chronic Diarrhoe, Head Pigmentation and Alopecia. Cronkhite-Canada Syndrome]." Deutsche Medizinische Wochenschrift (1946), vol. 135, no. 8, 2010, pp. 339-42.
Fischer R, Breidert M, Paul S, et al. [A patient with chronic diarrhoe, head pigmentation and alopecia. Cronkhite-Canada syndrome]. Dtsch Med Wochenschr. 2010;135(8):339-42.
Fischer, R., Breidert, M., Paul, S., Kreisel, W., Schmitt-Gräff, A., Waller, C., & Blum, H. E. (2010). [A patient with chronic diarrhoe, head pigmentation and alopecia. Cronkhite-Canada syndrome]. Deutsche Medizinische Wochenschrift (1946), 135(8), 339-42. https://doi.org/10.1055/s-0029-1244856
Fischer R, et al. [A Patient With Chronic Diarrhoe, Head Pigmentation and Alopecia. Cronkhite-Canada Syndrome]. Dtsch Med Wochenschr. 2010;135(8):339-42. PubMed PMID: 20165997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A patient with chronic diarrhoe, head pigmentation and alopecia. Cronkhite-Canada syndrome]. AU - Fischer,R, AU - Breidert,M, AU - Paul,S, AU - Kreisel,W, AU - Schmitt-Gräff,A, AU - Waller,C, AU - Blum,H E, Y1 - 2010/02/17/ PY - 2010/2/19/entrez PY - 2010/2/19/pubmed PY - 2010/3/17/medline SP - 339 EP - 42 JF - Deutsche medizinische Wochenschrift (1946) JO - Dtsch. Med. Wochenschr. VL - 135 IS - 8 N2 - HISTORY AND FINDINGS ON ADMISSION: A 70-year-old man with a 14 month history of chronic severe diarrhea treated with budenosid and mesalazin was admitted because of peripheral oedema and weight loss of about 26 kg. INVESTIGATIONS AND DIAGNOSIS: A general pigmentation of the skin, especially on scull and hands, as well as dystrophic nail changes and alopecia of scalp and facial hair were seen. The tests showed a slight macrocytotic, normochromic anemia. Total protein and the clotting factors were decreased. Endoscopy revealed multiple sessile polyps in the stomach and duodenum in appearance to colon and rectum. Endoscopic removal of a polyp showed histologically cystic dilatation of foveolae and oedematous mucosa. The histological features, the wide distribution of the polyps together with the skin changes, lead to the diagnosis of Cronkhite-Canada syndrome (CCS). TREATMENT AND COURSE: The patient was initially treated with prednisolon 60 mg/d i. v. for 2 weeks, resulting in a marked improvement of symptoms and weight gain. He is at present in good health under prednisolon 20 mg/d per os and is followed up in our outpatient department. CONCLUSION: CCS is in up to 14 % of the cases associated with a carcinoma of the gastrointestinal tract. At present there are only reports about a successful treatment by steroids, prophylactic gastrectomy and proctocolectomy. Typical myopathic lesions of CCS have not been described to date, but the demonstrated improvement of creatinin kinase with successful treatment suggests a common pathophysiological mechanism. SN - 1439-4413 UR - https://www.unboundmedicine.com/medline/citation/20165997/[A_patient_with_chronic_diarrhoe_head_pigmentation_and_alopecia__Cronkhite_Canada_syndrome]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1244856 DB - PRIME DP - Unbound Medicine ER -