Cronkhite-Canada症候群の1例―発症誘因に精神的ストレスの関与が示唆された1例

Cronkhite-Canada Syndrome, Report of a Case

要旨　患者は35歳，男性，公私にわたり精神的ストレスを自覚していた1995年9月から味覚異常，下痢が出現，更に脱毛，爪甲陥凹，手指の色素沈着を生じ，当科に紹介入院．入院時低蛋白血症を認め，消化管造影および内視鏡検査で胃から直腸までびまん性に浮腫状の無～亜有茎性ポリープを認めた．ポリープの病理組織検査で腺管の囊胞状拡張，間質の浮腫性変化を認め，Cronkhite-Canada症候群と診断した．入院後IVH管理・ステロイド経口投与により臨床症状および消化管ポリポーシスは著明に改善した．近年，本症候群の誘因としてストレスの関与が報告されており，本症例でも精神的ストレスの関与が示唆された．

　A 35-year-old man who had suffered from mental stress due to his private life and work was admitted to the hospital because of complaints including hypo-geusia, diarrhea, abdominal fullness, appetite loss, melena, alopecia, nail deformity, and pigmentation. The patient displayed characteristic clinical and pathological features of Cronkhite-Canada syndrome. After admission, intravenous hyperalimentation and steroid therapy reduced intestinal polyposis and improved his ability to take in nourishment together with all of his other complaints. He has been doing well with low-dose steroid maintenance therapy and there has been no signs of recurrence. This instructive case suggested that any mental stress may be a pathogenic factor able to induce this unusual syndrome.