Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Polyposis of gastrointestinal tract after COVID-19 mRNA vaccination: a report of two cases

  • Jun Ho Kim (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Eun Hye Oh (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Dong Soo Han (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
  • Received : 2023.10.19
  • Accepted : 2023.12.06
  • Published : 2024.05.30
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Abstract

Cronkhite-Canada syndrome is a rare gastrointestinal polyposis syndrome with distinctive clinical features and endoscopic findings. Diagnosis can be challenging without suspicion, and the disease carries high mortality due to complications such as infection, gastrointestinal bleeding, and malignancies. This paper presents two cases of Cronkhite-Canada syndrome occurring after coronavirus disease 2019 (COVID-19) mRNA vaccination. Both cases exhibited typical clinical findings, including hypogeusia, onychodystrophy, alopecia, and weight loss. Typical polyposis in the gastrointestinal tract was confirmed through endoscopies. As symptomatic treatment did not improve the symptoms, corticosteroids were administered, and symptoms and laboratory test results improved immediately. The patients improved upon corticosteroids tapering. These cases illustrate typical presentations of Cronkhite-Canada syndrome and the course of the disease following corticosteroid treatment. Additionally, they suggest the possibility that Cronkhite-Canada syndrome may be triggered by COVID-19 mRNA vaccination.

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References

  1. Wu ZY, Sang LX, Chang B. Cronkhite-Canada syndrome: from clinical features to treatment. Gastroenterol Rep (Oxf) 2020;8:333-342.
  2. Kwon J, Fluxa-Cardenas D, Francis D. Cronkhite-Canada syndrome. Clin Gastroenterol Hepatol 2022;20:e1224-e1225.
  3. Jiang CD, Myint H, Tie A, et al. Sustained clinical response to infliximab in refractory Cronkhite-Canada syndrome. BMJ Case Rep 2020;13:e236990.
  4. Kopacova M, Urban O, Cyrany J, et al. Cronkhite-Canada syndrome: review of the literature. Gastroenterol Res Pract 2013;2013:856873.
  5. Sweetser S, Ahlquist DA, Osborn NK, et al. Clinicopathologic features and treatment outcomes in Cronkhite-Canada syndrome: support for autoimmunity. Dig Dis Sci 2012;57:496-502.
  6. Fan RY, Wang XW, Xue LJ, et al. Cronkhite-Canada syndrome polyps infiltrated with IgG4-positive plasma cells. World J Clin Cases 2016;4:248-252.
  7. Ehrenfeld M, Tincani A, Andreoli L, et al. Covid-19 and autoimmunity. Autoimmun Rev 2020;19:102597.
  8. Caso F, Costa L, Ruscitti P, et al. Could Sars-coronavirus-2 trigger autoimmune and/or autoinflammatory mechanisms in genetically predisposed subjects? Autoimmun Rev 2020;19:102524.
  9. Zhou Y, Han T, Chen J, et al. Clinical and autoimmune characteristics of severe and critical cases of COVID-19. Clin Transl Sci 2020;13:1077-1086.
  10. Vojdani A, Kharrazian D. Potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases. Clin Immunol 2020;217:108480.
  11. Sapkota P, Gurung RB, Shrestha A, et al. Cronkhite-Canada syndrome: a case report. JNMA J Nepal Med Assoc 2022;60:473-477.
  12. Schonberger LB, Bregman DJ, Sullivan-Bolyai JZ, et al. Guillain-Barre syndrome following vaccination in the National Influenza Immunization Program, United States, 1976--1977. Am J Epidemiol 1979;110:105-123.
  13. Miller E, Waight P, Farrington CP, et al. Idiopathic thrombocytopenic purpura and MMR vaccine. Arch Dis Child 2001;84:227-229.
  14. Wraith DC, Goldman M, Lambert PH. Vaccination and autoimmune disease: what is the evidence? Lancet 2003;362:1659-1666.
  15. Segal Y, Shoenfeld Y. Vaccine-induced autoimmunity: the role of molecular mimicry and immune crossreaction. Cell Mol Immunol 2018;15:586-594.
  16. Chen Y, Xu Z, Wang P, et al. New-onset autoimmune phenomena post-COVID-19 vaccination. Immunology 2022;165:386-401.
  17. Miyawaki K, Komori T, Ishida Y, et al. Cronkhite-Canada syndrome mimicking COVID-19-related symptoms. Acta Derm Venereol 2022;102:adv00812.