P095 The Very Interesting Small Bowel Lesions of Cronkhite-Canada Syndrome
Bibliographic record
Abstract
BACKGROUND: Cronkhite-Canada syndrome (CCS) is a non-hereditary disease characterized by the presence of gastrointestinal polyposis and skin symptoms such as hair loss, nail plate atrophy, and skin pigmentation. Approximately 50% of cases of CCS also have small bowel lesions. However, there have been few image reports of the small intestine lesions. METHODS: We examined the findings of small intestine capsule endoscopy (CE) in 3 cases of CCS in our hospital. RESULTS: Case 1 was of a 64-year-old male whose chief complaint was diarrhea, abnormal taste, and weight loss. He had diarrhea for 2 months and aware of finger pigmentation and nail atrophy. Esophagogastroduodenoscopy (EGD) revealed a collection of reddish polyps that expanded in the stomach and duodenum, and colonoscopy (CS) revealed glossy reddish bumps in the colon. CE showed diffuse reddish, edematous mucosa and villi enlargement in the entire small bowel. From these characteristic endoscopic and skin findings, he was diagnosed with CCS and was started on prednisolone (PSL) treatment. The treatment response was good, and there was no relapse. Case 2 was of a 65-year old female whose chief complaint was skin pigmentation. She had been aware of pigmentation on her back, palms, and upper arms, and loss of fingernails for the last 6 years with repeated disappearances and exacerbations. Furthermore, erosive gastritis and gastric hyperplastic polyps had been detected 4 years ago, and she was followed-up for these symptoms. Gradually, she became aware of nausea and loose stools, which prompted her to visit our hospital. EGD and CS revealed multiple reddish polyps predominantly in the gastric antrum, villous atrophy and reddish polyps in the terminal ileum, and scattered reddish polyps in the entire colon. Mucosal biopsies revealed glandular dilation, mucosal edema, and inflammatory cell infiltration. CE showed diffuse mulberry ridges and villi atrophy throughout the small bowel. She was diagnosed with CCS based on characteristic clinical and endoscopic findings, and was started on steroid treatment. There was no relapse. Case 3 was of a 75-year old male whose chief complaint was diarrhea and hair loss. EGD and CS revealed multiple polyps in the stomach, duodenum, and colon. CE showed reddish edematous mucosa and villi mixed with atrophy and swelling in the small bowel. Of note were that these findings were found in the jejunum. He was diagnosed with CCS and started on PSL and immunomodulator. Four years later, the characteristic findings disappeared in the CE. CONCLUSION(S): All patients had lesions in the entire small bowel, but there they were not associated with clinical findings or steroid response. The mucosa of the small intestine were more likely to have various findings as the period from onset to diagnosis became longer.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".