Department of Gastroenterology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Scand J Gastroenterol. 2022 Aug;57(8):958-964. doi: 10.1080/00365521.2022.2048885. Epub 2022 Mar 15.
Cronkhite-Canada syndrome (CCS) is a rare disease that is characterized by multiple gastrointestinal polyps and ectodermal abnormalities. This study aimed to improve the understanding of CCS by presenting our patient data.
Clinical features, treatment, and outcomes of four CCS patients at a single medical center were retrospectively analyzed.
The age of the patients ranged from 32 to 61 years (mean: 49.5 years), including three men and one woman. All the patients presented with gastrointestinal symptoms, ectodermal abnormalities, and multiple gastrointestinal polyps. Two patients showed abnormal immune indices. Three patients underwent magnetic resonance enterography, and the typical manifestations of small intestine involvement were diffuse wall thickening, high signal intensity on diffusion-weighted imaging, obvious enhancement, and multiple small nodular enhancements of the small intestine. The main histological manifestations were chronic inflammation and hyperplastic, adenomatoid, and hamartomatoid polyps. Eosinophilic infiltration was observed in two patients. One patient had rectal adenocarcinoma at the time of diagnosis. All the four patients received prednisone at a dose of 0.75-1 mg/kg/day, and had their gastrointestinal symptoms gradually resolved (including two with ectodermal abnormality and endoscopic remission). Two patients are currently receiving low-dose prednisone (2.5-5 mg/day) with no recurrence after a 1.5- and 6-year follow-up periods, respectively.
Magnetic resonance enterography has the potential to evaluate small-intestinal lesions in CCSs. Long-term therapy with low doses of prednisone may be beneficial in maintaining remission.
Cronkhite-Canada 综合征(CCS)是一种罕见疾病,其特征为多发性胃肠道息肉和外胚层异常。本研究旨在通过呈现我们的患者数据来提高对 CCS 的认识。
回顾性分析了单一医疗中心的 4 例 CCS 患者的临床特征、治疗和结局。
患者年龄 32-61 岁(平均 49.5 岁),包括 3 名男性和 1 名女性。所有患者均有胃肠道症状、外胚层异常和多发性胃肠道息肉。2 例患者存在免疫指标异常。3 例行磁共振肠造影,小肠受累的典型表现为弥漫性肠壁增厚、弥散加权成像高信号、明显强化和小肠多发小结节强化。主要组织学表现为慢性炎症和增生性、腺瘤样和错构瘤样息肉。2 例患者可见嗜酸性粒细胞浸润。1 例患者在诊断时患有直肠腺癌。4 例患者均接受泼尼松治疗,剂量为 0.75-1mg/kg/d,胃肠道症状逐渐缓解(包括 2 例伴有外胚层异常和内镜缓解)。2 例患者目前接受低剂量泼尼松(2.5-5mg/d)治疗,分别随访 1.5 年和 6 年无复发。
磁共振肠造影有助于评估 CCS 的小肠病变。长期低剂量泼尼松治疗可能有助于维持缓解。