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Pediatric Cronkhite-Canada Syndrome Follow-up

  • Author: Simon S Rabinowitz, MD, PhD, FAAP; Chief Editor: Carmen Cuffari, MD  more...
Updated: Nov 17, 2015

Further Outpatient Care

See the list below:

  • Although remissions may persist for longer than 10 years, patients must be monitored for nutritional deficiencies.
  • Patients should regularly undergo upper endoscopy and colonoscopy because 10% of patients with Cronkhite-Canada syndrome develop GI (stomach, colon) cancer. Guidelines for colorectal cancer screening have been established by the American College of Gastroenterology.[27] . The authors of a large multicenter Japanese studying describing over 200 patients suggest annual surveillance colonoscopy.[2]
  • Steroid therapy, which is expected to diminish the inflammatory polyp burden, should precede endoscopic surveillance to assist in the identification of malignancy. Advanced endoscopic techniques, including narrow-band imaging, magnifying endoscopy, and dye-based contrast-enhanced techniques, have been used to improve sensitivity.[2]

Further Inpatient Care

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  • Hyperalimentation, including electrolytes, minerals, protein, vitamins, dextrose, and lipids, are given because of the clinically significant losses of nutrients and fluid from the GI tract.
  • Monitor the patient for impending surgical complications.

Inpatient & Outpatient Medications

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  • The literature does not support prophylactic therapy.
  • All therapy should be individualized for the patient's specific symptoms and complications.


See the list below:

  • Consider transferring the patient to an intensive care unit for surgical intervention, diagnostic and therapeutic GI endoscopy, and parenteral hyperalimentation.


See the list below:

  • Specific recommendations are not available.
  • Epidemiologic data do not suggest specific infectious etiology.


See the list below:

  • Dehydration, electrolyte abnormalities, and shock
  • Kwashiorkor and various nutritional deficiencies
  • Small bowel overgrowth, systemic infections, and sepsis
  • Anemia related to GI blood losses and deficiencies
  • Edema, anasarca, and congestive heart failure
  • Thromboembolic phenomena
  • Reportedly high rates of surgical complications
  • Secondary immune deficiencies


See the list below:

  • Early reports indicated a grave prognosis. Large series have shown that more than one half of affected patients have a remission; long-term survivors are reported.
  • Survival largely depends on adequate and sometimes prolonged intensive care.
  • Although the diagnosis depends on alopecia, nail dystrophy, or pigmentation changes, the prognosis is related to only the GI mucosal pathology.

Patient Education

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  • Patients who go into remission should promptly report any change in GI symptoms or weight loss to their physicians.
  • Regular surveillance endoscopy is important for long-term survivors.
  • Patients should be reassured that Cronkhite-Canada syndrome is neither contagious nor familial.
Contributor Information and Disclosures

Simon S Rabinowitz, MD, PhD, FAAP Professor of Clinical Pediatrics, Vice Chairman, Clinical Practice Development, Pediatric Gastroenterology, Hepatology, and Nutrition, State University of New York Downstate College of Medicine, The Children's Hospital at Downstate

Simon S Rabinowitz, MD, PhD, FAAP is a member of the following medical societies: American Gastroenterological Association, American Academy of Pediatrics, Phi Beta Kappa, American Association for the Advancement of Science, American College of Gastroenterology, American Medical Association, New York Academy of Sciences, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Sigma Xi

Disclosure: Nothing to disclose.


Kanika Puri, MD Resident Physician, Department of Pediatrics, State University of New York Downstate Medical Center, Brooklyn

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

David A Piccoli, MD Chief of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia; Professor, University of Pennsylvania School of Medicine

David A Piccoli, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

Disclosure: Nothing to disclose.

Chief Editor

Carmen Cuffari, MD Associate Professor, Department of Pediatrics, Division of Gastroenterology/Nutrition, Johns Hopkins University School of Medicine

Carmen Cuffari, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Royal College of Physicians and Surgeons of Canada

Disclosure: Received honoraria from Prometheus Laboratories for speaking and teaching; Received honoraria from Abbott Nutritionals for speaking and teaching.

Additional Contributors

Chris A Liacouras, MD Director of Pediatric Endoscopy, Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia; Associate Professor of Pediatrics, University of Pennsylvania School of Medicine

Chris A Liacouras, MD is a member of the following medical societies: American Gastroenterological Association

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous coauthor Dr Minoj Sheth to the development and writing of this article.

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