Ｐｌｕｍｍｅｒ‐Ｖｉｎｓｏｎ症候群の１例

Abstract

Plummer-Vinson syndrome is clinically characterized by manifestations such as dysphagia, atrophic glossitis, angular cheilitis, and koilonychia. The syndrome is associated with an irondeficiency anemia. This occurs in about 7% of iron-deficient subjects. Further, this syndrome usually affects middle-aged females. In this paper, however, the case of a male patient is reported. In October, 1987, a 63 year-old man came to our hospital for consultation. He complained of sore mouth and slight difficulty in swallowing. As for his past medical history, about 30 years earlier, he had undergone a surgical operation for a duodenal ulcer. With regard to his present complaint, he had noticed the symptoms three years earlier, at which time he consulted local medical doctors, but nothing abnormal was found. Several weeks prior to his appearance at our hospital, the symptoms had increased in severity and so he sought medical advice.Clinical examination revealed brittle, spoon-shaped finger nails. Furhter, the corners of his mouth were cracked. Intraorally, the tongue was red, glossy, and smooth, owing to atrophy of the papillae. The patient was completely edentulous and uses full dentures.Laboratory tests then were conducted. A complete blood count revealed a microcytic hypochromic anemia and a further investigation including serum ferritin concentration disclosed an iron-deficiency anemia with anisocytosis and poikilocytosis. Barium contrast radiograph showed the normal esophagus and the gastrojejunostomy (the Billroth II operation) for the previous duodenal ulcer. These clinical and laboratory findings led to the diagnosis of Plummer-Vinson syndrome. He was started on a medical regimen of iron preparation to replace iron loss. He responded well to this therapy and the symptoms disappeared in five weeks. Since then his progress has been followed and he remains free of the disease.