COLONIC HAMARTOMATOUS POLYPOSIS ASSOCIATED WITH HYPERTROPHIC OSTEOARTHROPATHY

A 7-year-old girl with an unremarkable family history was admitted wit h complaints of diarrhea containing mucus and blood, abdominal pain, w eight loss and fever for 10 months. Although her symptoms, physical ex amination and laboratory results were highly suggestive of inflammator y bowel disease, radiologic studies and colonoscopy demonstrated multi ple colonic polyps. A bilateral and symmetric lamellar periosteal reac tion and osteopenia were present on her extremity radiographs. The che st radiograph and thoracic CT scan were normal. The histologic nature of the polyps was determined as hamartoma. One month after subtotal co lectomy, the patient's symptoms resolved and she gained 7 kg in weight . The association of generalized juvenile polyposis and hypertrophic o steoarthropathy has previously been described in five cases; arteriove nous malformations were present in four of them. In our case the polyp s were hamartomatous and localized in the colon, without associated ar teriovenous malformation.