Gastrointestinal polyposis with protein-losing enteropathy, abnormal skin pigmentation and loss of hair and nails (Cronkhite-Canada syndrome)

A patient with Cronkhite-Canada syndrome, myxedema and muscle atrophy

A case of Cronkhite-Canada syndrome is presented. The patient had alopecia, onychodystrophy and gastrointestinal polyposis, mainly in the stomach and duodenum, with transient diarrhea and hypoproteinemia. Marked atrophy and weakness of the shoulder girdle muscles due to myopathy were also present. In addition she had primary hypothyroidism. The outcome of the disease is usually fatal within months, but so far our patient is alive four years after the onset of symptoms. The pathological changes, pathophysiology, symptoms, course and treatment of this rare disorder of unknown etiology are discussed.

Cronkhite-Canada syndrome. Light and electron microscopy of the cutaneous pigmentary abnormalities

This article describes the light and electron microscopic studies from a macule and the surrounding lightly hyperpigmented skin of a patient with the Cronkhite-Canada syndrome. Increased numbers of melanin granules in keratinocytes, increased numbers of melanosomes in melanocytes, and areas with increased numbers of melanocytes were found in the macular lesion. Skin from both the macule and surrounding area were also characterized by compact hyperkeratosis as well as perivascular inflammation and exocytosis not previously reported in these patients.

Cronkhite-Canada syndrome: radiologic features

We report 6 cases of Cronkhite-Canada syndrome, analyze the patterns of involvement, and review the literature on this entity. There were 4 women and 2 men, with an average age of 58 years. The stomach was diseased diffusely in 5 and focally (distally) in 1. Small bowel polyps were detected in 4 patients. Patterns of involvement were classified as (a) innumerable small polyps carpeting large areas, (b) scattered varying-size polyps, and (c) sparse involvement with few small polyps. There was concordance of patterns between the stomach and colon in 5 of the 6 patients.

Spontaneous improvement of Cronkhite-Canada syndrome in a postpartum female

A case report of a 34-year-old female with the Cronkhite-Canada syndrome is presented. The patient developed the characteristic clinical features of intestinal polyposis, skin pigmentation, alopecia, and onychodystrophy which later resolved. An unusual feature was that symptoms developed during the postpartum period. This is the youngest female patient described with the syndrome. The etiology, pathophysiology, clinical manifestations, and management of the Cronkhite-Canada syndrome are reviewed.

The Cronkhite-Canada syndrome

The eighteenth patient and seventh survivor with the Cronkhite-Canada syndrome is described. A remission of 9 years followed gastrectomy and steroid therapy. Findings on seventeen other patients described in the literature are reviewed.

The histological features are discussed in detail. The jejunum, though macroscopically normal, showed oedema, increased vascularity and mucous gland secreting activity. The possible importance of this increased vascularity in the aetiology of this syndrome is discussed.