Cap polyposis: an inflammatory disorder or a spectrum of mucosal prolapse syndrome?

We read with great interest the letter by Maunoury and colleagues ( Gut 2005; 54 :313–14). They reported on a case of cap polyposis unresponsive to infliximab, in contrast with the successful report by Bookman and colleagues.1 Maunoury et al stated that the success with infliximab reported by Bookman et al might have been due to spontaneous regression of cap polyposis. Maunoury et al speculated that a role for tumour necrosis factor α (TNF-α) in the pathogenesis of this rare disorder was unacceptable and other mechanism, such as abnormal colonic motility, may be important. The pathogenesis of cap polyposis …