Cronkhite-Canada Syndrome Treatment & Management

  • Author: Agnieszka B Serwin, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 24, 2012
 

Medical Care

Because of the unknown etiology, treatment remains predominantly symptomatic. Controlled therapeutic trials have not been possible because of the rarity of the disease. Remissions may occur spontaneously.

  • The primary goal of the treatment is to correct fluid, electrolyte, and protein loss, and to regulate stool frequency. These measures help improve the patient's general condition. Most patients need symptomatic treatment for abdominal pain.
  • The most effective treatment is combination therapy composed of systemic corticosteroids together with an antiplasmin, an elemental diet, and hyperalimentation (nutritional supplements). Antibiotics are used to correct intestinal bacterial overgrowth. The indication for corticosteroids is gastrointestinal inflammation; however, its origin is not clear. Nutritional supplementation comprises oral and/or intravenous fluids, electrolytes, vitamins, minerals, amino acids, albumins, and lipids. Transfusions because of severe anemia or acute blood loss sometimes are required. In one reported case with elevated gastric acid secretion, the patient responded very well to ranitidine therapy.[28] Other medications used are sulfasalazine and metronidazole.
  • After H pylori eradication, gastric polypectomy can be of value.[20]
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Surgical Care

  • At present, surgery is available only for complications of Cronkhite-Canada syndrome, such us prolapse, bowel obstruction, and malignancy.
  • Other authors suggest that surgical intervention should also be reserved for patients who are not responsive to conservative methods.
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Consultations

  • Gastroenterologist consultation always is required to establish number, localization, and size of polypoid lesions.
  • Consultation with a surgeon can help determine if surgical intervention is necessary.
  • Acute brain syndrome requires psychiatrist consultation.
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Proceed to Medication
 
 
Contributor Information and Disclosures
Author

Agnieszka B Serwin, MD  Consulting Staff, Department of Dermatology and Venereology, Medical Academy of Bialystok, Poland

Disclosure: Nothing to disclose.

Coauthor(s)

Hanna Mysliwiec, MD  Staff Physician, Department of Dermatology and Venereology, Medical Academy of Bialystok, Poland

Disclosure: Nothing to disclose.

Specialty Editor Board

Franklin Flowers, MD  Chief, Division of Dermatology, Professor, Department of Medicine and Otolaryngology, Affiliate Associate Professor of Pediatrics and Pathology, University of Florida College of Medicine

Franklin Flowers, MD, is a member of the following medical societies: American College of Mohs Micrographic Surgery and Cutaneous Oncology

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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  2. Ho V, Banney L, Falhammar H. Hyperpigmentation, nail dystrophy and alopecia with generalised intestinal polyposis: Cronkhite-Canada syndrome. Australas J Dermatol. Nov 2008;49(4):223-5. [Medline].

  3. Daniel ES, Ludwig SL, Lewin KJ, Ruprecht RM, Rajacich GM, Schwabe AD. The Cronkhite-Canada Syndrome. An analysis of clinical and pathologic features and therapy in 55 patients. Medicine (Baltimore). Sep 1982;61(5):293-309. [Medline].

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  11. Vernia P, Marcheggiano A, Marinaro V, Morabito S, Guzzo I, Pierucci A. Is Cronkhite-Canada Syndrome necessarily a late-onset disease?. Eur J Gastroenterol Hepatol. Oct 2005;17(10):1139-41. [Medline].

  12. Yasuda T, Ueda T, Matsumoto I, Shirasaka D, Nakajima T, Sawa H, et al. Cronkhite-Canada syndrome presenting as recurrent severe acute pancreatitis. Gastrointest Endosc. Mar 2008;67(3):570-2. [Medline].

  13. Naoshima-Ishibashi Y, Murofushi T. A case of Cronkhite-Canada syndrome with vestibular disturbances. Eur Arch Otorhinolaryngol. Nov 2004;261(10):558-9. [Medline].

  14. Sweetser S, Alexander GL, Boardman LA. A case of Cronkhite-Canada syndrome presenting with adenomatous and inflammatory colon polyps. Nat Rev Gastroenterol Hepatol. Aug 2010;7(8):460-4. [Medline].

  15. Bruce A, Ng CS, Wolfsen HC, Smallridge RC, Lookingbill DP. Cutaneous clues to Cronkhite-Canada syndrome: a case report. Arch Dermatol. Feb 1999;135(2):212. [Medline].

  16. Yashiro M, Kobayashi H, Kubo N, Nishiguchi Y, Wakasa K, Hirakawa K. Cronkhite-Canada syndrome containing colon cancer and serrated adenoma lesions. Digestion. 2004;69(1):57-62. [Medline].

  17. Hutnik CM, Nichols BD. Cataracts in systemic diseases and syndromes. Curr Opin Ophthalmol. Feb 1999;10(1):22-8. [Medline].

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  19. Nakayama M, Muta H, Somada S, et al. Cronkhite-Canada syndrome associated with schizophrenia. Intern Med. 2007;46(4):175-80. [Medline].

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  21. Hanzawa M, Yoshikawa N, Tezuka T, et al. Surgical treatment of Cronkhite-Canada syndrome associated with protein-losing enteropathy: report of a case. Dis Colon Rectum. Jul 1998;41(7):932-4. [Medline].

  22. Bacher T, Schonekas H, Steurer KT, Wunsch PH. [The Cronkhite-Canada Syndrome. A rare differential diagnosis of generalized gastrointestinal polyposis]. Dtsch Med Wochenschr. May 23 1997;122(21):676-81. [Medline].

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  26. Okamoto K, Isomoto H, Shikuwa S, Nishiyama H, Ito M, Kohno S. A case of Cronkhite-Canada syndrome: remission after treatment with anti-Helicobacter pylori regimen. Digestion. 2008;78(2-3):82-7. [Medline].

  27. Burke AP, Sobin LH. The pathology of Cronkhite-Canada polyps. A comparison to juvenile polyposis. Am J Surg Pathol. Nov 1989;13(11):940-6. [Medline].

  28. Allbritton J, Simmons-O'Brien E, Hutcheons D, Whitmore SE. Cronkhite-Canada syndrome: report of two cases, biopsy findings in the associated alopecia, and a new treatment option. Cutis. Apr 1998;61(4):229-32. [Medline].

  29. Takahura M, Adachi H, Tsuchihashi N. A case of Cronkhite-Canada Syndrome markedly improved with mesalazine therapy. Digest Endos. 2004;16:74-8.

  30. Sampson JE, Harmon ML, Cushman M, Krawitt EL. Corticosteroid-responsive Cronkhite-Canada syndrome complicated by thrombosis. Dig Dis Sci. Apr 2007;52(4):1137-40. [Medline].

 
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