Hair Loss and Polyposis in Cronkhite-Canada Syndrome
Bibliographic record
Abstract
A 42-year-old woman presented with watery diarrhea and abdominal pain for approximately 4 weeks. Two weeks after the onset of gastrointestinal symptoms, scalp hair loss occurred. Physical examination revealed marked hair loss (Figure A) and atrophy of fingernails. Esophagogastroduodenoscopy revealed numerous granular, hyperplastic mucosal changes in the stomach (Figure B). Colonoscopy revealed multiple inflammatory polyps throughout the large bowel. Based on these findings, Cronkhite-Canada syndrome (CCS) was diagnosed. Systemic administration of 50 mg/d predonisone resolved the gastrointestinal symptoms in 1 month and alopecia in 6 months (Figure C). Prednisone dosage was gradually reduced over 10 months and then discontinued. Follow-up esophagogastroduodenoscopy post-treatment showed complete resolution of the gastric polyps (Figure D). Approximately 2 years after prednisone discontinuation, mild diarrhea recurred, and CCS recurrence was confirmed on endoscopy. Four years have passed with no recurrence after discontinuation of the second prednisone course. CCS is a rare noninherited disease characterized by gastrointestinal non-neoplastic polyposis and ectodermal abnormalities, including alopecia, onychodystrophy, and hyperpigmentation. CCS is classified into 5 types based on whether diarrhea (type I, as in this case), hypogeusia (type II), thirst or abnormal sensation in the mouth (type III), abdominal discomfort other than diarrhea (type IV), or alopecia (type V) is the initial symptom. In this case, as alopecia occurred 2 weeks after the onset of diarrhea, it could have been caused by acute telogen effluvium, although it may occur as the initial symptom before the onset of gastrointestinal symptoms as in other reported cases. There are many unclear points about the pathogenesis of hair loss in CCS, and further analysis is needed.
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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 | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".