Cronkhite-Canada syndrome: An elusive gastrointestinal disorder with multisystem involvement-pathogenesis, diagnosis, and therapeutic strategies

Figure 1  Flowchart of the study selection process.

Figure 2  Potential etiological factors that may cause Cronkhite-Canada syndrome.

Figure 3  Common clinical features of Cronkhite-Canada syndrome.

Figure 4 Flowchart demonstrating the diagnostic approach used for Cronkhite-Canada syndrome. Patients, who present with nail and connective tissue changes without any digestive disturbances, should be advised to perform laboratory tests. In case of normal results, follow up and symptomatic treatment is advised. However, patients with abnormal laboratory test results and those who had digestive symptoms along with nail and connective tissue changes at the time of presentation should undergo endoscopy. If multiple polyps with pathological features are found during endoscopy, diagnosis of Cronkhite-Canada Syndrome (CCS) is established. If polyps are absent and there are no mucosal changes, follow up and symptomatic treatment is recommended. For patients who demonstrate mucosal changes, biopsy should be performed. If non-specific signs of inflammation are detected, such patients are advised regular follow-ups and symptomatic treatment. However, if eosinophilic infiltration is identified in biopsy specimen, diagnosis of CCS should be considered. CCS: Cronkhite-Canada syndrome; FOBT: Fecal occult blood test; CBC: Complete blood count; LFT: Liver function test; CRP: C-reactive protein; TFT: Thyroid function test.

Figure 5 Treatment strategies used for Cronkhite-Canada syndrome. NSAIDs: Non-steroidal anti-inflammatory drugs; H. pylori: Helicobacter pylori.