Objective To investigate the characteristics and clinical significance of serum immunoglob-ulins in patients with Cronkhite-Canada syndrome(CCS).Methods This retrospective study included CCS patients admitted to Peking Union Medical College Hospital from December 2009 to September 2024 who under-went serum immunoglobulin testing.Clinical manifestations and ancillary examination results were analyzed ret-rospectively.Results Fifty-two patients were included(male:36[69.2%],female:16[30.8%]),with median onset age of 60(54-64)years and median diagnostic delay of 5(3-12)months.Common manifesta-tions included diarrhea(86.5%),abdominal pain(40.4%),hematochezia(19.2%),weight loss(86.5%),nail malnutrition(100.0%),pigmentation(88.5%),hair loss(84.6%),and hypogeusia(69.2%).Serum IgG reduction occurred in 21 patients(50.0%),while total IgE elevation was observed in 20(71.4%).Elevated serum IgG4 levels were noted in 11 patients(23.4%),with no significant clinical differences between IgG4-elevated and normal groups.IgG4 levels showed no statistical difference between active(n=43)and remission(n=27)groups.The hair loss rate was significantly higher in the total IgE-ele-vated group than that in the normal total IgE group(P=0.0383).Conclusions CCS patients exhibit periph-eral blood immunoglobulin disorders,with elevated IgE levels correlating with hair loss.This suggests an im-mune-mediated mechanism may underlie hair loss in CCS.

Auto-brewery syndrome(ABS)is a rare and easily overlooked disease.Overgrowth of certain high-alcohol-producing fungi and bacteria in the intestine leads to the production of endogenous ethanol that ex-ceeds the liver's maximum metabolic capacity,resulting in an elevated ethanol concentration in the patient's peripheral blood.Even without alcohol intake,patients may exhibit symptoms similar to intoxication,causing various social,occupational,and health-related distress.This article provides an overview of the diagnosis and differential diagnosis of ABS,reveals that gut microbiota dysbiosis is the core of ABS,and introduces multiple intervention strategies involving the regulation of the gut microbiota,including dietary intervention,pharmaco-therapy,probiotic therapy,fecal microbiota transplantation,and phage therapy,with the aim of assisting clini-cians in the early identification and treatment of ABS.

Auto-brewery syndrome(ABS)is a rare and easily overlooked disease.Overgrowth of certain high-alcohol-producing fungi and bacteria in the intestine leads to the production of endogenous ethanol that ex-ceeds the liver's maximum metabolic capacity,resulting in an elevated ethanol concentration in the patient's peripheral blood.Even without alcohol intake,patients may exhibit symptoms similar to intoxication,causing various social,occupational,and health-related distress.This article provides an overview of the diagnosis and differential diagnosis of ABS,reveals that gut microbiota dysbiosis is the core of ABS,and introduces multiple intervention strategies involving the regulation of the gut microbiota,including dietary intervention,pharmaco-therapy,probiotic therapy,fecal microbiota transplantation,and phage therapy,with the aim of assisting clini-cians in the early identification and treatment of ABS.

Objective To investigate the characteristics and clinical significance of serum immunoglob-ulins in patients with Cronkhite-Canada syndrome(CCS).Methods This retrospective study included CCS patients admitted to Peking Union Medical College Hospital from December 2009 to September 2024 who under-went serum immunoglobulin testing.Clinical manifestations and ancillary examination results were analyzed ret-rospectively.Results Fifty-two patients were included(male:36[69.2%],female:16[30.8%]),with median onset age of 60(54-64)years and median diagnostic delay of 5(3-12)months.Common manifesta-tions included diarrhea(86.5%),abdominal pain(40.4%),hematochezia(19.2%),weight loss(86.5%),nail malnutrition(100.0%),pigmentation(88.5%),hair loss(84.6%),and hypogeusia(69.2%).Serum IgG reduction occurred in 21 patients(50.0%),while total IgE elevation was observed in 20(71.4%).Elevated serum IgG4 levels were noted in 11 patients(23.4%),with no significant clinical differences between IgG4-elevated and normal groups.IgG4 levels showed no statistical difference between active(n=43)and remission(n=27)groups.The hair loss rate was significantly higher in the total IgE-ele-vated group than that in the normal total IgE group(P=0.0383).Conclusions CCS patients exhibit periph-eral blood immunoglobulin disorders,with elevated IgE levels correlating with hair loss.This suggests an im-mune-mediated mechanism may underlie hair loss in CCS.