‘Canada Syndrome’ Responsible for Woman’s Diarrhea, Hair Loss, and Purple Skin for Six Months

A woman in Hong Kong was diagnosed with a rare condition after she experienced severe diarrhea, weight loss, hair loss and other bizarre symptoms for six months.

The unnamed woman, 43, was admitted to the Prince of Wales Hospital in Hong Kong with complaints of abdominal pain and diarrhea up to ten times per day. Upon further examination, doctors also found that she was experiencing hair loss at her scalp and discolored skin on her face, arms and legs. She also reported losing 5 kg of weight — around ten pounds — and a reduced appetite since symptoms began.

The physicians, who published a case report on the incident in the New England Journal of Medicine, initially believed that traditional Chinese medicine could be to blame. The woman reported beginning a traditional treatment 10 months before. These medicines could have been causing either an adrenal insufficiency — when the body does not produce certain hormones in large enough quantities — or poisoning from toxic metals such as lead or mercury.

The doctors even speculated that it could be cancer, as the disease often causes weight loss and in some cases can display gastrointestinal issues early on.

However, all of these theories came up empty. The woman’s blood and urine work was clean and the Chinese medicine she used did not contain toxic metals. 

Doctors then performed a colonoscopy, and discovered polyps in her colon. They described them as having a “strawberry-like appearance”. These can sometimes indicate cancer, as forms of colorectal cancer will often begin with polyp growths in the colon. However, doctors determined that they were not cancerous.

Instead, they diagnosed the woman with a condition called Cronkhite-Canada Syndrome. This is an extremely rare condition only documented around 500 times. It occurs when polyps that interfere with the digestive system and cause other issues begin to grow in the colon. It is unclear what causes the condition to develop. 

Doctors attempted to treat the woman with cyclosporin, a drug used by organ transplant recipients to suppress the immune system, and a steroid called prednisolone. Cases of Canada syndrome are so rare that there is no standard treatment, but in previous cases this combination of drugs had shown promise.

However, they did not work for this woman. Next, doctors tried infliximab, another immunosuppressant. This drug performed better, with her skin and hair seeing recovery and a colonoscopy finding that some of the polyps had regressed.

The woman’s condition continued to deteriorate, though. The diarrhea remained frequent, and it began to cause her malnourishment. Her calcium and vitamin D levels became extremely low, leading to her forming brittle bones. She experienced multiple fractures. 

More than two years after the initial diagnosis she would experience a lung blockage and pneumonia. She would die of respiratory failure.