Vedolizumab as a Second Line Biologic for Cronkhite Canada Syndrome and an Approach Toward Disease Monitoring

A 62-year-old woman was diagnosed with Cronkhite-Canada Syndrome, presenting with classic clinical symptoms and endoscopic findings. She initially responded to infliximab (IFX) with symptomatic improvement, normalized calprotectin, and minimal disease activity on endoscopy for 3 years. Despite IFX trough levels appropriate for inflammatory bowel disease goals and no IFX antibodies, she subsequently lost response and had recurrence of symptoms and disease activity. She started on a course of corticosteroids, discontinued IFX, and transitioned to vedolizumab with standard induction and maintenance dose every 8 weeks, achieving clinical remission and near complete endoscopic remission.