A case of Cronkhite-Canada syndrome treated by steroid pulse therapy

A 47-year-old man visited our hospital with the chief complaints of diarrhea, dysgeusia, alopecia and onychodystrophy. Endoscopic examinations revealed an edematous and reddish mucosa and many polypoid lesions in the stomach and colon. Cronkhite-Canada syndrome was diagnosed and the patient was treated with intravenous prednisolone. The symptoms improved gradually, however, remission was not achieved. At one month after treatment, the serum albumin level still persisted. We then decided to administer steroid pulse therapy. With this therapy, the symptoms improved dramatically, and steroid maintenance therapy was initiated with betamethasone, which has a longer half-life than prednisolone. The patient’s condition improved, and repeat endoscopy revealed improvement of the polypoid lesions and mucosal inflammation. This case indicates that steroid pulse therapy may be useful for at least a proportion of patients with Cronkhite Canada syndrome, and may also be useful for helping in deciding the treatment policy.