Aoun Elie, Victain Michelle, Mitre Marcia C
Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, West Penn Allegheny Health System, Pittsburgh, Pennsylvania, United States.
BMJ Case Rep. 2011 Sep 19;2011:bcr0820114640. doi: 10.1136/bcr.08.2011.4640.
A 71-year-old male presented with nausea, diarrhoea and weight loss. He had mild to moderate alopecia, paucity of eyebrow hair, erythematous non-pruritic nodular rash on the wrists, toenail onychomychosis and scalp hyperpigmentation. A colonoscopy revealed an irregular, haemorrhagic 5 cm rectosigmoid mass. Biopsies revealed mucin distended glands and focal ischemic changes. A CT scan showed numerous polypoid-like lesions in the stomach. Upper endoscopy showed mucosal erythema and nodularity with polypoid-like lesions. Biopsies showed cystic glandular dilatation, lamina propria oedema and chronic inflammation consistent with Cronkhite-Canada syndrome (CCS). The patient was started on nutrition supplementation. His skin manifestations were treated topically and with mineral supplements. He improved within 10 weeks and is currently asymptomatic. A high index of suspicion for CCS should exist in patients who present with weight loss, diarrhoea and polyposis. If diagnosed early, the disease can be treated with the goal of clinical remission.
一名71岁男性出现恶心、腹泻和体重减轻症状。他有轻度至中度脱发、眉毛稀少、手腕上有红斑性非瘙痒性结节性皮疹、趾甲甲癣和头皮色素沉着。结肠镜检查发现乙状结肠直肠交界处有一个5厘米的不规则出血性肿块。活检显示粘蛋白扩张的腺体和局灶性缺血改变。CT扫描显示胃内有许多息肉样病变。上消化道内镜检查显示黏膜红斑和结节，伴有息肉样病变。活检显示囊性腺体扩张、固有层水肿和慢性炎症，符合克朗凯特-加拿大综合征（CCS）。患者开始接受营养补充。他的皮肤表现采用局部治疗和补充矿物质的方法。他在10周内有所改善，目前无症状。对于出现体重减轻、腹泻和息肉病的患者，应高度怀疑CCS。如果早期诊断，该疾病可以通过临床缓解为目标进行治疗。
