Clin Endosc.  2024 May;57(3):402-406. 10.5946/ce.2023.268.

Polyposis of gastrointestinal tract after COVID-19 mRNA vaccination: a report of two cases

• Kim JH
• Oh EH
• Han DS

• KMID: 2555902
• DOI: http://doi.org/10.5946/ce.2023.268

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.

Keyword

Adverse event; COVID-19; Cronkhite-Canada syndrome; Vaccines

Figure

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  Fig. 1. Onychodystrophy of the Case 1 patient’s fingernails.

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  Fig. 2. Endoscopic findings of the Case 1 patient’s gastrointestinal tract. (A) Numerous erythematous polyps in the stomach. (B) Numerous erythematous polyps in the colon. (C) Atrophied villi in the duodenum. (D) Atrophied villi in the terminal ileum.

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  Fig. 3. Follow-up endoscopic findings of the Case 1 patient’s gastrointestinal tract. (A) Most of the polyps in the stomach disappeared on follow-up endoscopy. (B) Most of the polyps in the colon disappeared on follow-up endoscopy.

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  Fig. 4. Onychodystrophy of the Case 2 patient’s fingernails.

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  Fig. 5. Endoscopic findings of the Case 2 patient’s gastrointestinal tract. (A) Numerous erythematous polyps in the stomach. (B) Numerous erythematous polyps in the colon. (C) Atrophied villi in the duodenum. (D) Dilated villi in the terminal ileum.

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