Diarrhea: alert for rare gastrointestinal polyposis

  What is Cronkhite-Ganada syndrome?  Cronkhite-Ganada syndrome is a rare, non-genetic, specific polyposis, and most scholars now believe that the polyps in this disease are juvenile-type misshapen-like polyps. Clinical findings include skin pigmentation, alopecia, and hypoproteinemia. The tissue consists of a monomorphic gland covered with a single layer of columnar mucous epithelium, a mucus-filled capsule, and a congested, edematous interstitium infiltrated by plasmacytoid neutrophils.  Cronkhite-Ganada was previously thought to be an adenomatous polyp, but was later found to be a misshapen polyp.  The main clinical features of Cronkhite-Ganada syndrome are: 1. adult onset, preferably in the elderly, with no family history of polyposis; 2. polyps are found throughout the gastrointestinal tract, and endoscopically they are mostly diffuse and scattered, especially in the gastric sinus, mostly without a tip, with a diameter of 0.5-1.0 cm, smooth surface and soft texture; 3. histological changes are mostly similar to juvenile polyps, with glandular cystic dilatation, containing protein-fibrous fluid and chronic edema of the lamina propria, without malignant tendency; 4. There are ectodermal changes, such as hair loss, nail dystrophy and hyperpigmentation.  The clinical manifestations of Cronkhite-Ganada syndrome are: Clinical manifestations are most common with diarrhea, which is present in 80% of cases, with large bowel movements and may contain fat or fleshy blood. Most patients have significant weight loss, followed by abdominal pain, anorexia, fatigue, vomiting, and loss of libido and taste. Almost always there are nail changes, hair loss, and hyperpigmentation.  Treatment principles for Cronkhite-Ganada syndrome: The treatment principles are symptomatic treatment, nutritional therapy, antibiotic therapy and glucocorticoids and anabolic hormones, but also plasma products. Although cases of survival for more than 10 years have been reported, the disease is generally severe and the prognosis is poor, with causes of death including malnutrition, cachexia, heart failure, pneumonia, sepsis, and shock.