[Weight loss, diarrhea and dystrophic alterations of the fingernails in an 80-year-old male patient]

Cronkhite-Canada syndrome (CCS) is a rare noninherited condition characterized by gastrointestinal polyposis, alopecia, onychodystrophy, hyperpigmentation, weight loss and diarrhea. We report the case of an 80-year-old patient presenting with weight loss, diarrhea and dystrophic changes of the fingernails. The symptoms began 3 months prior to the admission. In the outpatient area an esophagogastroduodenoscopy and a coloscopy had already been performed, showing a polyposis of the stomach and an unclear generalized colitis. The admission was due to a progressive worsening of the patient's physical condition including further weight loss. The endoscopy showed an unusual continuous ileopancolitis as well as a polyposis of the stomach. The histological examination revealed hyperplastic polyps with a marked stromal edema. Together with the ectodermal changes a CCS was diagnosed and treatment with corticosteroids, intravenous nutrition and proton pump inhibitors was initiated. In the further course of the hospital stay a moderately reduced left ventricular function was diagnosed and the patient had to be temporarily monitored in the intensive care unit due to a prolonged QTc time. In the follow-up 3 months later the patient showed good clinical and endoscopic response to the treatment with cessation of the diarrhea, weight gain of 8 kg and regrowth of the fingernails and head hair; however, the left ventricular function remained moderately impaired.

Keywords: Colitis; Colonic neoplasms; Heart failure; Intestinal polyposis; Malnutrition.