消化管ポリープの縮小ないし消失を示したCronkhite-Canada症候群の1例

A Case of Cronkhite-Canada's Syndrome: Disappearance of polyps in the digestive tract

　Cronkhite-Canada症候群¹⁾は，胃，小腸，大腸にわたる広汎なポリポージス，皮膚の色素沈着，脱毛，爪甲の萎縮，低蛋白血症のみられる非遺伝性のきわめて稀な疾患である．最近，われわれは全身症状の改善と共に消化管ポリープの縮小ないし消失を認めた本症候群の1例を経験したので報告する．

　A man aged 49 had acute onset of diarrhoea, loss of hair and nails along with skin pigmentation. Until eight months before admission he had been active and well with no relevant personal or family history.

　Diffuse pigmentation faded to a few spotty pigmentation on hands and feet without any specific therapy by dermatologist. Hairs and nails grew again, but the nails remained dark and atrophic. As he still complained of watery diarrhoea, he was admitted to the hospital in Oct. 1973. Laboratory investigation revealed marked hypoproteinemia (3.9 g/dl), hypo-potassemia (3.2 mEq/l) and hypoacidity of gastric juice. All the function tests of the liver were normal.

　Roentgenographic examination of the digestive tract showed diffuse polyposis in the stomach, colon and rectum. A few small polyps were also seen in the small intestine. Endoscopy of the stomach revealed innumerable hemispheric polyps in the antrum.

　Microscopic picture of the polyps was cystic dilatation of glands, mucus hypersecretion and cellular infiltration. There was no evidence of malignant changes.

　He was given high protein diet, plasma (200～300 ml) intravenously and 25 mg Durabolin once a week intramuscularly. After four months diarrhoea subsided and he gained weight. Roentgenographic and endoscopic examinations one year after admission showed only some small polyps in the stomach and a few in the colon and rectum. The patient was free of any abnormal findings after Dec. 1975.

　The progress of illness in this case suggests the presence of a temporary infective or toxic cause.