An Unusual Case of Gastrointestinal Polyposis

Abstract

Question: A 55-year-old man presented our hospital with a 5-month history of nausea, dysgeusia, anorexia, hypoesthesia of the fingers, and a 10-kg weight loss. The patient’s personal medical history and family history were unremarkable. Careful physical examination revealed slight alopecia of the scalp, mild onychodystrophy of the finger nails and toenails, hyperpigmentation on the forehead, and brown, pigmented skin macules over the left calf (Figure A). Laboratory investigations disclosed albumin level of 35.3 g/L (reference range, 40–55 g/L), immunoglobulin M level of 0.192 g/L (reference range, 0.4–2.3 g/L), and 25-hydroxyvitamin D3 level of 18.5 ng/mL (reference range, 30–100 ng/mL).