Wang S1, Cao H1, Zhou J1, Feng S2, Jiang K1.
Gastrointest Endosc. 2020 Apr 17. pii: S0016-5107(20)34171-7. doi: 10.1016/j.gie.2020.04.019. [Epub ahead of print]
A 69-year-old woman was seen with diarrhea for 16 years (more than 20 times in recent 6 months). She underwent total colectomy 16 years ago because of multiple colon polyps but without final diagnosis. Physical examination revealed that the distal parts of her nail beds were soft and thick and had fallen off (A), and the hyperpigmented patches could be found on her face, arms, legs, and even her tongue (B). The laboratory results showed a serum albumin level of 23g/L (normal range 35-55 g/L). The blue laser imaging system (BLI) illustrated multiple polyps with dilatation of the mucosal gland and irregular vessels in the esophagus (C), stomach, small intestine (D), and rectum. Histological findings demonstrated hamartoma polyps, hyperplastic mucosal gland, cystic dilatation of mucosal gland, diffuse edema in the intestine, and adenoma in the rectum. Thus, a diagnosis of Cronkhite-Canada syndrome (CCS) was established. To our knowledge, few esophagus lesions in the case of CCS have been reported. Moreover, this case presented the first BLI finding in CCS, and evaluation of potential value of BLI for the early diagnosis of CCS is further required. Our patient’s symptoms were relieved during follow-up by treating with lansoprazole, dexamethasone, and human albumin.
1 Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China
2 Department of Geriatrics, General Hospital, Tianjin Medical University, Tianjin, China