Case Of Plummer-Vinson Syndrome Research Articles

Endoscopic Submucosal Dissection for Esophageal Squamous Cell High-grade Dysplasia in a Patient with Plummer Vinson Syndrome

AbstractA 35-year female with Plummer Vinson syndrome (PVS) presented with a history of progressive dysphagia over six months, not responding to iron therapy and endoscopic dilatations. Her upper gastrointestinal endoscopy showed a post-cricoid web dilated using a Savary-Gilliard dilator. On NBI, a long segment circumferential lesion with abnormal microvascular architecture was noted in the mid esophagus. Biopsy showed high-grade dysplastic squamous epithelium. The patient underwent minimally invasive, circumferential endoscopic submucosal dissection (ESD) and received oral prednisolone to prevent stricture formation. Resected margins were free of dysplasia. At follow-up there was no evidence of recurrence or stricture formation. To our knowledge, this is the first case of PVS with squamous proliferation with high-grade dysplasia that was successfully treated with circumferential ESD. Screening endoscopy helps in the downstaging of early cancer, and timely intervention helps to treat this with a minimally invasive approach like ESD.

Plummer–Vinson syndrome: A case series

Plummer–Vinson syndrome (PVS), also known as Paterson–Brown–Kelly syndrome, is characterized by a triad of dysphagia, upper esophageal web, and iron deficiency anemia. It predominantly affects middle-aged females. The postcricoid webs are associated with a higher risk of squamous cell carcinoma; therefore, timely diagnosis and treatment is important. Herein, we report three cases of PVS.

Plummer-Vinson Syndrome With Concomitant Factor VII Deficiency

Background: Plummer-Vinson syndrome (PVS), a rare disorder characterized by dysphagia, iron deficiency anemia, and esophageal webs, has principally been described in middle-aged women. This disorder is uncommon in the 21st century because of the abundance of iron-fortified foods. Clotting factor deficiencies are also rare. Factor VII deficiency is a bleeding disorder characterized by the absence of a critical protein in the coagulation cascade. Case Report: We present a case of PVS associated with factor VII deficiency in a 26-year-old African American female. The patient had a history of anemia that was repeatedly attributed to menstrual bleeding and dysphagia for 10 years. She presented with symptomatic anemia requiring transfusion. She reported a history of food getting stuck in her chest, and workup revealed esophageal webs with no evidence of overt luminal gastrointestinal bleeding. Coagulation laboratory tests revealed the incidental finding of a borderline increased prothrombin time. Hematologic studies confirmed the presence of factor VII deficiency. Conclusion: To our knowledge, no case has been published about a patient diagnosed with PVS and concomitant factor VII deficiency. Our case illustrates several learning points: (1) PVS is an uncommon disorder that may still be diagnosed in a developed country in the 21st century; (2) PVS requires close follow-up and esophageal surveillance because of the increased risk of esophageal cancer; (3) factor VII exhibits a high degree of phenotypic variability; (4) phenotype in factor VII deficiency does not always correlate with factor VII activity, although life-threatening spontaneous bleeding is not expected with levels >2%.

Plummer-Vinson Syndrome: A Rare Entity in Sub-Saharan Africa

Plummer-Vinson syndrome (PVS) is a rare condition characterized by classical triad; high dysphagia, iron-deficiency anemia and oesophageal ring formation. We report a case of PVS in a 62-year-old patient admitted to the department of gastroenterology and internal medicine for high dysphagia. The clinical examination showed anemic syndrome, general impairment and polyarthritis. Biological examinations concluded to iron deficiency anemia. The endoscopy had observed a circular ring immediately above Killian’s mouth ruptured during the examination. The patient was treated with iron and proton pump inhibitors. The oesophageal symptomatology regressed completely from the second day of treatment.

Plummer Vinson Syndrome in a Young African American Female: A Rare Entity

Plummer Vinson syndrome (PVS), also known as Paterson-Brown-Kelly syndrome, is a rare clinical condition characterized by a triad of iron deficiency anemia, esophageal webs, and dysphagia. PVS has been rarely reported in African American females. In this case, however, we report a 26-year-old African American female with a 10-year history of iron deficiency anemia, who presented with severe fatigue and dysphagia. Her work-up revealed severe iron deficiency anemia, and upper endoscopy showed two esophageal rings. A 26-year-old African American female presented with severe fatigue, headache, and dysphagia for 5 months. The dysphagia was predominantly to solid foods compared to liquids. Patient also has a 10-year history of iron deficiency anemia and has stopped taking iron supplementations for the last 2 years. Physical examination revealed severe conjunctival pallor but was otherwise normal. Routine investigations revealed severe microcytic anemia with hemoglobin of 4.2 g/dL, mean corpuscular volume of 62.5 fL, and a ferritin level of 2 ng/dL. A modified barium swallow study showed two esophageal impressions in the cervical region, which were concerning for esophageal webs. Patient later underwent an esophagogastroduodenoscopy (EGD) which showed two upper esophageal rings; one semi-circumferential at 15 cm and a second circumferential at 17 cm from the incisors. A pediatric size scope was used to bypass the rings. She was initiated on iron replacement therapy with no symptomatic improvement of her dysphagia after 6 months of treatment. She then had a follow up EGD with wire-guided savary dilation with 8 mm dilator which resulted in an immediate improvement of her symptoms. Patient remained symptom free in her 2 months follow-up. PVS is characterized by iron deficiency anemia, esophageal webs, and dysphagia. It is predominantly seen in middle aged Caucasian females. Our case is unique because only a few cases of PVS have been reported in African American females. PVS is also a precancerous condition. Therefore, patients with this syndrome are at increased risk of developing gastrointestinal squamous cell carcinomas. Since nutritional deficiency is one of the major causes of iron deficiency anemia, the improvement in nutritional status of populations worldwide has led to a decreased incidence of PVS. Dysphagia in PVS usually responds to iron supplementation. However, resistant cases may require endoscopic dilatation of the webs as in our patient.1776_A Figure 1. EGD image Showing the first upper esophageal web, 15 cm from the incisors.1776_B Figure 2. EGD image Showing the second esophageal web, 17 cm from the incisors.1776_C Figure 3. Esophageal ring post wire-guided savary dilation with a satisfactory mucosal tear shown.

Plummer Vinson syndrome in children: case series

Plummer Vinson syndrome (PVS) is a rare entity in children and classically presents with a triad of anemia, dysphagia and post cricoid web. We report four paediatric cases of PVS reported in a tertiary care institute in Chennai, India over a period of 6 years. All children were above 5 years of age with M:F of 1:3. Mean duration of symptomatology was 13.5 months. Mean age at the diagnosis was 9.3 years. Classical triad of PVS was seen in all of our children who responded well to endotherapy without any recurrence. Though rare in children case series of PVS are highlighted to stress the importance of evaluation, when children present with dysphagia and anemia and the necessity of early referral to paediatric GI centre for successful management.

A Case of Plummer-Vinson Syndrome and Celiac Disease

Introduction: Plummer-Vinson syndrome is a triad of iron deficiency anemia, dysphagia, and cervical esophageal web. Celiac disease and Plummer-Vinson syndrome are both known to be associated with iron deficiency. There are very few reported cases of both being seen in the same patient. We report a case of a female found to have Plummer-Vinson syndrome along with celiac disase. Case report: We present a case of a 48 year old female with a long standing history of iron deficiency anemia. She had been following up with her primary care physician for a number of years for iron deficiency anemia and had extensive workup done. She required intermittent blood transfusions and was on B12 and Iron. She had been seen by gastroenterology 5 years prior to this visit, at that time it was recommended she have an upper endoscopy and colonoscopy which she refused due to being pregnant at the time. She was told to follow up with gastroenterology for an upper endoscopy and colonoscopy after her pregnancy was over. Years later she re-presented with anemia and dysphagia. An upper endoscopy and colonoscopy were scheduled. Upper endoscopy demonstrated a benign appearing intrinsic stenosis 24 cm from the incisors. A pediatric endoscope was required to traverse the web-like stenosis in the proximal esophagus. Duodenal biopsies were taken to check for celiac disease. Colonoscopy showed the entire colon to be normal. Duodenal biopsies were consistent with immune-mediated injury such as gluten sensitivity. She was thought to have Plummer-Vinson syndrome in the setting of iron deficiency anemia secondary to celiac disease. It was recommended that the patient adhere to a gluten free diet. The patient was scheduled for upper endoscopy for esophageal dilation but was again lost to follow-up. Conclusion: Plummer-Vinson syndrome is a triad of iron deficiency anemia, dysphagia, and a cervical esophageal web. Celiac disease and Plummer Vinson syndrome are rarely seen coinciding together in the same patient. Important point to remember is that if a patient is thought to have Plummer-Vinson syndrome they should be worked up for celiac disease as a cause of iron deficiency anemia. This case demonstrates this importance of keeping in mind that Plummer-Vinson syndrome and celiac disease can coexist in the same patient.

A Case of Plummer-Vinson Syndrome in an Afro-Caribbean Female

Plummer-Vinson is defined by the classic triad of dysphagia, iron deficiency anemia and upper esophageal web(s). Although quite rare, and predominantly found in white, middle aged women, we report a case of PV in a middle-aged Afro-Caribbean female managed with mechanical dilation and iron supplementation. A 43 year old female presented with progressive dysphagia to liquids and solids for a duration of 2 years. Several weeks prior to presentation she reported several episodes of regurgitating undigested food. A review of systems was significant for a 50-lb weight loss, headaches and fatigue. She was given a diagnosis of anemia by her General Practitioner approximately 12 years prior to presentatiion but no additional work up was done. She denied menorrhagia, hematuria, hematochezia, and any gastrointestinal symptoms. She denied taking any NSAIDS. On examination, her blood pressure was 164/99 mmHg and her pulse rate was 67 beats per minute and regular. She was afebrile. Mucus membranes were pale but moist. Evaluation of the mouth revealed atrophic glossitis and there was pallor of the nail beds but no koilonychia. Systemic examination revealed an ejection systolic murmur over the precordium but no other abnormalities. Laboratory investigations showed a hemoglobin of 5.6 g/dl with a mean corpuscular volume of 54.9 fl. White blood cell count was 4.51 K/ul and platelets were 311,000 K/μl. The serum iron was 13 μg/dl, iron saturation 3%, and serum ferritin 3ng/mL. Alanine transaminase, serum creatinine and Thyroid Stimulating Hormone were within normal limits. A modified barium swallow revealed a short smooth segment of stenosis immediately inferior to the pharynx and anterior to the 4thcervical vertebrae. An upper endoscopy confirmed a smooth mucosal narrowing 24cm from the incisors, consistent with a mucosal web. The gastroscope was advanced with gentle pressure into the stomach and proximal duodenum; both were normal. Biopsies were taken from the gastric body and antrum and the revealed chronic active gastritis associated with intestinal metaplasia, H. pylori organisms were not identified. Multiple biopsies taken from the proximal duodenum showed no evidence of celiac disease. A Continuous Radial Expansion balloon was used to dilate the stricture to 15mm. On the first post operative day the patient had significant improvement in her symptoms and was able to tolerate a regular diet. She was discharged on Ferrous Sulphate 325mg and Vitamin C 1000mg daily. Repeat iron studies performed 8 weeks later showed a serum iron of 17 ug/dl and a serum ferritin of 6ng/ml.Figure 1Figure 2

A Case of Plummer-Vinson Syndrome and Celiac Disease

Introduction: Plummer-Vinson syndrome is a triad of iron deficiency anemia, dysphagia, and cervical esophageal web. Celiac disease and Plummer-Vinson syndrome are both known to be associated with iron deficiency. There are very few reported cases of both being seen in the same patient. We report a case of a female found to have Plummer-Vinson syndrome along with celiac disase. Case report: We present a case of a 48 year old female with a long standing history of iron deficiency anemia. She had been following up with her primary care physician for a number of years for iron deficiency anemia and had extensive workup done. She required intermittent blood transfusions and was on B12 and Iron. She had been seen by gastroenterology 5 years prior to this visit, at that time it was recommended she have an upper endoscopy and colonoscopy which she refused due to being pregnant at the time. She was told to follow up with gastroenterology for an upper endoscopy and colonoscopy after her pregnancy was over. Years later she re-presented with anemia and dysphagia. An upper endoscopy and colonoscopy were scheduled. Upper endoscopy demonstrated a benign appearing intrinsic stenosis 24 cm from the incisors. A pediatric endoscope was required to traverse the web-like stenosis in the proximal esophagus. Duodenal biopsies were taken to check for celiac disease. Colonoscopy showed the entire colon to be normal. Duodenal biopsies were consistent with immune-mediated injury such as gluten sensitivity. She was thought to have Plummer-Vinson syndrome in the setting of iron deficiency anemia secondary to celiac disease. It was recommended that the patient adhere to a gluten free diet. The patient was scheduled for upper endoscopy for esophageal dilation but was again lost to follow-up. Conclusion: Plummer-Vinson syndrome is a triad of iron deficiency anemia, dysphagia, and a cervical esophageal web. Celiac disease and Plummer Vinson syndrome are rarely seen coinciding together in the same patient. Important point to remember is that if a patient is thought to have Plummer-Vinson syndrome they should be worked up for celiac disease as a cause of iron deficiency anemia. This case demonstrates this importance of keeping in mind that Plummer-Vinson syndrome and celiac disease can coexist in the same patient.

A Rare Case Report of Esophageal Web (Plummer Vinson Syndrome) in Adolescent Male

Plummer-Vinson syndrome (PVS) is characterized by dysphagia, iron deficiency anemia and upper esophageal web. It is predominantly a disease of middle-aged females and very rarely seen in childhood. To date only nine cases of PVS have been reported in the English-language literature in children and adolescents. We report a case of this uncommon syndrome with an uncommon presentation. An 18-year-old male presented with complains of easy fatigability, palpitation and under-developed secondary sexual characters. On examination he was severely pale, with kylonichia, easy pluckable hair and delayed secondary sexual characters. Investigations for cause of anemia revealed microcytic hypochromic anemia in peripheral smear with Hb 5 g/dl, TC 5300 cells/mm3, Platelet 9 lakh/mm3, Thyroid profile was normal, serum ferritin levels were 13.8 ng/ml. Not able to find a definitive cause for iron deficiency, anemia history was revisited and the patient complained of mild dysphagia since age 9 years for solids greater than liquids. Upper gastrointestinal endoscopy was done which showed upper esophageal web with the endoscope not able to pass through the web. Blood transfusion and symptomatic treatment was given and patient symptoms improved. On follow-up, repeat blood picture showed hemoglobin of 12 g/dl and patient is doing well with iron supplements. Esophageal web (plummer vinson syndrome) is usually seen in women and is rarely documented in adolescent male. A careful history-taking and knowledge of occurrence of this rare disorder will benefit patients. Delayed secondary sexual characters may be due to chronic malnutrition due to the dysphagia caused by the web in the esophagus.

Síndrome de Plummer-Vinson: relato de caso

We present a case of Plummer-Vinson syndrome, which is a rare condition nowadays. The diagnosis was made after years of the disease, many doctors having attended the patient. The treatment consisted of oral supplementation of iron and endoscopic dilatations. The patient is asymptomatic.

Safety and Effectiveness of Endoscopic Savary-Gillaard Bougies Dilation in Moroccan Plummer-Vinson Syndrome Patients

The authors aimed to better define the clinical, biological, radiological, endoscopic, and evolutionary characteristics of patients presenting with Plummer-Vinson syndrome after endoscopic dilation and medical treatment in this study. There were 41 cases of Plummer-Vinson syndrome listed. All these patients presented dysphagia associated to anemia, and all have benefited endoscopic dilation and iron supplementation with a good clinical and biological course in 100% of cases. The Plummer-Vinson syndrome is a rare entity. The treatment, based essentially on endoscopic dilations, is effective and safe.

A case of Plummer-Vinson syndrome in childhood

The Plummer-Vinson syndrome is characterized by an association of dysphagia, iron-deficiency anemia, and esophageal webs. The authors report the case of a 6 year old with Plummer-Vinson syndrome. Plummer-Vinson syndrome usually occurs in adults, rarely in adolescents, however, there have been no previous reports in the English-language literature of the syndrome occurring in childhood.

味覚異常を伴ったＰｌｕｍｍｅｒ‐Ｖｉｎｓｏｎ症候群の１例

This paper described a case of Plummer-Vinson syndrome and developmental changes of 4 primary taste qualities; sweet, sour, bitter and salty.In the patient, a male aged 78, a typical iron-deficiency anemia state was comfirmed by routine hematology. The tongue was very smooth because of atrophy of the filiform papillae and he had spoon-shaped nails. Slight difficulty of swallowing was also complained. Taste threshold values and difference threshold values of 4 taste qualities increased with this patient, especially sweet, sour and salty. Bitter was the only taste usually recognized.Following treatment with iron derivatives, there was much improvement and abnormal findings almost disappeared. The taste threshold values and difference threshold values for 4 taste qualities gradually decreased with improvement of iron-deficiency anemia. Therefore the taste abnormality of this patient was caused by atrophy of the papillae of tongue from irondeficiency anemia.

Ｐｌｕｍｍｅｒ‐Ｖｉｎｓｏｎ症候群患者にみられた口腔癌の１例

Plummer-Vinson syndrome (PVS) has been known as one of the pre-cancerous conditions, especially because PVS patients have atropic mucous membrane that is excessive irritable.Recently, we experienced a case of PVS with three cancerous lesions in the oral cavity. The patient was a 57 year old female whose chief complaint was the swelling of right upper lip. In addition, she had a twenty years history of dysphagia.The oral cancerous lesions consisted of a thumb tip size tumor of the right upper lip mucosa, the same size tumor of the right cheek mucosa and a red bean size tumor of the right retromolar pad mucosa. Histopathologically, all of them were squamous cell carcinomas. A right submandibular lymph node was elongated.Another clinical findings were a red smooth tongue, fissuring at the commisures of lipand spoon-shaped nails. Laboratory findings revealed a typical iron deficiency anaemia. On barium swallow examination, esophageal web was recognized.The patient was treated by oral administration of iron therapy and the transfusion of concentrated red cells for the anaemia. The oral cancerous lesions were excised surgically after the preoperative radiation.There is no sign of recurrences of the oral lesions for one and a half years after surgery.

Two cases of Plummer-Vinson syndrome

Two cases of Plummer-Vinson syndrome

Two cases of Plummer-Vinson syndrome

Two cases of Plummer-Vinson syndrome

Post-cricoid carcinoma in plummer-vinson syndrome in males

Two cases of Plummer-Vinson syndrome in males, in whom latter developed post cricoid carcinoma, in a very young age, have been presented with discussion.

Plummer-Vinson syndrome: Report of a case

A case of Plummer-Vinson syndrome has been reported. The importance of its early diagnosis is emphasized, and the significant role of serum iron in maintaining the health and integrity of the oral epithelium is discussed.

A case of plummer-vinson syndrome

A case of plummer-vinson syndrome