Plummer-Vinson Research Articles

Accidentally Confirmed Relapse of Plummer-Vinson Syndrome during Esophageal Foreign Body Evaluation

Plummer-Vinson syndrome (PVS) is a complex condition characterized by a classic triad of dysphagia, iron deficiency anemia (IDA), and an upper esophageal web. Dysphagia represents the most important symptom of PVS and is usually observed with solid food. Therapeutic options for dysphagia include iron supplementation and/or endoscopic balloon dilation based on symptom severity. PVS can be treated easily and regular iron replacement therapy can prevent disease progression. We describe a 63-year-old woman diagnosed with a simple esophageal web, who underwent esophageal dilation 13 years prior to presentation. However, she revisited our center because of dysphagia secondary to an esophageal foreign body, and endoscopy revealed esophageal web relapse. Investigations revealed IDA, and the patient was eventually diagnosed as PVS. She underwent successful endoscopic dilation and denied recurrent dysphagia after continuous intake of iron tablets. We recommend continuous management of IDA, as well as endoscopic dilation and a multidisciplinary therapeutic approach to ensure favorable prognosis in PVS patients.

Determining the frequency of Plummer Vinson Syndrome among patients having dysphagia presenting at district Bahawalpur

BACKGROUND & OBJECTIVE: Plummer Vinson syndrome (PVS) is a rare triad of dysphagia, iron deficiency, and esophageal webs. This study aims to assess the frequency of PVS in patients presenting with dysphagia.
 METHODOLOGY: A cross-sectional study was conducted at the Department of Otolaryngology from 1st April 2020 to 31st March 2021. A total of 164 patients having dysphagia for a minimum of two weeks duration were enrolled. The patient's data was recorded using a pre-designed questionnaire for PVS assessments, complete blood count, serum ferritin levels and barium swallow test results were obtained, and a radiologist was consulted for the upper esophageal web.
 RESULTS: The observed frequency of PVS among patients with dysphagia was 11(6.7%). Female gender turned out to be significantly associated with PVS occurrence (p=0.001), while age (p=0.748) and duration of dysphagia (p=1.00) showed no significant association with it. Among those with PVS, 72.7% of patients were >40 years of age, 90.9% were females, and 81.8% had a duration of dysphagia >4 weeks. 
 CONCLUSION: It is concluded that PVS is not very frequent among patients with dysphagia. But since it increases the risk of squamous cell carcinoma of the pharynx and the esophagus, therefore, such patients should be followed closely for the presence of PVS and treated promptly to avoid morbidity and mortality.

Oral Health - A Mirror of Plummer Vinson Syndrome

A lack of significant iron in the normal red blood cells leads to iron deficiency anaemia (IDA). Plummer Vinson Syndrome (PVS) is a syndrome with the clinical triad of symptoms of iron deficiency anaemia, dysphagia and oesophageal webs. Repeated injury to epithelia due to iron deficiency leads to atrophy of mucosa and degradation of pharyngeal muscles, leading to the development of oesophageal webs. Oral manifestations are the initial symptoms and oral cavity is the mirror of the systemic conditions of the body. Henceforth dentists play a major role in promptly diagnosing the oral health of an individual. Under this background, we present a case of Plummer Vinson Syndrome with oral manifestations. Keywords: Anaemia, Iron deficiency, Plummer Vinson Syndrome, Haemoglobin, Dysphagia, Oesophageal webs, Endoscopy, Oral Health.

S2435 A Rare Case of Plummer-Vinson Syndrome Treated With Pneumatic Dilations and Iron Supplementation

Introduction: Plummer-Vinson Syndrome (PVS), also known as Paterson-Kelly syndrome, presents with a classic triad of dysphagia, iron-deficiency anemia and esophageal webs. Although this triad of disease is increasingly less prevalent, early detection and intervention are imperative to reduce mortality given increased risk of malignant transformation.1 Case Description/Methods: A 22-year-old female with a history of iron deficiency anemia presented to the emergency department with syncope in the setting of palpitations and dyspnea. The patient endorsed alarm symptoms including hematochezia over the past 6 weeks, 20-lb unintentional weight loss and dysphagia. Initial labs were remarkable for a hemoglobin of 11.1 g/dL, and microcytic indices, with an MCV of 72.4 fL. The patient underwent esophagogastroduodenoscopy (EGD) to investigate the etiology of iron deficiency anemia. EGD revealed a prominent esophageal web (Figure A) in the proximal esophagus with associated erythema and mucosal friability. Significant narrowing impeded safe passage of the endoscope and thus serial pneumatic dilations to 10 mm were performed. Following pneumatic dilation, the endoscope was successfully advanced beyond the web (Figure B) to the gastroesophageal junction. The patient tolerated the procedure well and had immediate resolution of dysphagia following EGD with pneumatic dilation. She was then continued on iron supplementation as previously prescribed at discharge. Discussion: Plummer-Vinson Syndrome comprises the pathological triad of dysphagia, esophageal web, and iron deficiency anemia. Other signs and symptoms can include glossitis, angular cheilitis, and koilonychia. The decreased incidence of this syndrome parallels the decreased prevalence of iron deficiency in the developed world. Iron deficiency induces an iron-dependent enzyme dysfunction which causes oxidative stress, mucosal DNA damage and ultimately potentiates the formation of esophageal webs. 2 Without intervention, patients with this syndrome may develop absolute dysphagia, aspiration pneumonia and other complications. Due to increased risk of malignancy, surveillance EGDs are necessary to screen for esophageal carcinoma in patients with PVS.Figure 1.: Esophageal Web pre dilation (a) and post dilation (b).

Serum ferritin: A hidden gem for diagnosing plummer vinson syndrome

Plummer-Vinson syndrome (PVS) is a triad of dysphagia, iron deficiency anemia and upper esophageal web. Early diagnosis with adequate treatment is necessary to prevent its malignant transformation. To represent different clinical pictures of PVS and to evaluate the treatment outcome and determine its prevalence. This is a descriptive study with study population of 267 patients with dysphagia and 40 had PVS. Post cricoid webs were dilated and post-operative iron correction was done. Patients are on regular follow up. Analysis showed highest incidence in females with dysphagia being the main presenting complaint in all the patients. All had iron deficiency and 90% of patients had post cricoid web. PVS is a precancerous condition. Serum ferritin should be the preferred parameter for diagnosing iron deficiency anemia. Regular follow up is warranted to prevent malignant progression.

Plummer–Vinson syndrome: A rare case of dysphagia in a middle aged female

Plummer–Vinson syndrome: A rare case of dysphagia in a middle aged female

Benign Stenosis of Oesophagus: About 101 Cases in the Digestive Endoscopy Department of the General Idrissa Pouye Hospital (Dakar, Senegal)

Introduction: Benign oesophageal strictures are defined as narrowing of the oesophageal lumen not related to neoplastic pathology. They are frequently encountered during endoscopic practice and are often responsible for a reduction in the quality of life of patients due to the appearance of dysphagia. In sub-Saharan Africa, little data are available on these benign esophageal strictures. The objective of our study was to determine the sociodemographic, diagnostic and therapeutic aspects of benign oesophageal strictures in a digestive endoscopy centre in Senegal. Patients and Methods: This was a retrospective, descriptive study analysing reports of upper GI endoscopies performed between January 2015 and December 2017 in a hospital in Senegal. Reports that concluded to have non-neoplastic oesophageal stenosis were collated. Sociodemographic data, indications for and results of endoscopy, and therapeutic modalities were collected. These data were analysed using the Sphinx version 5 software. Results: We collected 101 cases of benign oesophageal stenosis, representing a prevalence of 2.1% in the endoscopy centre. The mean age of the patients was 34 years (range 2 and 83 years) with a median of 37.9 years. There was a female predominance with a sex ratio of 0.38 (73 females). Dysphagia, the main symptom, was present in 87 patients (86.1% of cases) with a Dysphagia score greater than or equal to 2 in 51 patients (50.5%). The average duration of this dysphagia, excluding caustic stenosis, was 4 years (extremes 1 and 15 years). Endoscopy revealed simple stenosis in 76 cases (75.2% of cases). A membranous ring of the cervical oesophagus, suggestive of the Plummer-Vinson syndrome ring, was found in 60 patients (59.4% of cases) and was the primary cause; other aetiologies were dominated by caustic stenosis (19 cases), Schatzki rings (8 cases) and peptic stenosis (4 cases). Endoscopic dilatation was performed in 90 patients (89.1% of cases) with Savary Gilliard bougies (87 cases) and hydrostatic balloons (3 cases). The average number of dilatation sessions was 1.69. In 10 patients (11.1%), refractory stenosis was observed. This stenosis could be resolved after further dilatation in 8 cases before the 8th session. In 2 patients, dilatation failed. Conclusion: Benign oesophageal strictures in our digestive endoscopy centre in Senegal mainly affect young adults, with a predominance of women. Diagnosis is often late. Cervical oesophageal rings in the context of Plummer-Vinson syndrome are the main cause. Oesophageal dilatation with bougies is of great therapeutic value.

Plummer-Vinson syndrome in primary Sjögren syndrome: a case-based review

This study aimed to describe a patient with Sjögren syndrome who developed Plummer-Vinson syndrome, and to review the literature and describe shared aspects of this rare association. A systematic screening of articles was conducted in PubMed/MEDLINE, LILACS, SciELO, Scopus, Web of Science, and Cochrane, dating 1940 to 2020. All the articles included the association between Sjögren syndrome and Plummer-Vinson syndrome. No language restriction was applied. The following terms were used: "Sjögren syndrome" or "sicca syndrome" and "Plummer-Vinson syndrome" or "Paterson-Kelly syndrome." We performed our analysis by adding our present case, with a total of 4 cases. Three out of four were female (75%), age varied from 56 to 58years old. In 2 cases, Sjögren syndrome preceded Plummer-Vinson syndrome diagnosis, and in 1 report, Plummer-Vinson syndrome appeared before Sjögren syndrome. Disease duration varied from 7 to 20years. In two cases, autoantibodies were available, and antinuclear antibodies and anti-Ro/SS-A were positive in both, and anti-La/SS-B in one of them was associated with anti-dsDNA; however, no data regarding lupus was available in the article. Treatment involved iron supplementation in 3/3. Two out of three received parenteral iron supplementation, and in these two cases, mechanical esophageal dilatation was needless. In the other case, an additional endoscopic esophageal dilatation was necessary to receive the oral iron supplement. All 3 cases had a good outcome. This case illustrates a patient with Sjögren syndrome who developed the rare Plummer-Vinson syndrome. In Sjögren syndrome, the presence of iron-deficiency anemia, dysphagia, and weight loss should alert the physician to search for associated Plummer-Vinson syndrome.

Plummer-Vinson Syndrome

Plummer-Vinson syndrome is a classical triad of dysphagia, iron-deficiency anemia and esophageal webs, Plummer-Vinson or Paterson-Kelly syndrome occurs. There is no exact data on the epidemiology of the condition; the syndrome is extremely rare. Most of the patients are middle-aged white women, but the syndrome has also been identified in children and adolescents in the fourth to seventh decades of life. Over the years, dysphagia is typically painless and sporadic or incremental, restricted to solids and often related to weight loss. The association with upper alimentary tract cancers is one of the most significant clinical aspects of Plummer-Vinson syndrome. Etiopathogenesis is unknown due to Plummer-Vinson syndrome

Plummer-Vinson Syndrome in an African American Woman Secondary to Menorrhagia: a Case Report

Plummer-Vinson Syndrome in an African American Woman Secondary to Menorrhagia: a Case Report

Plummer-Vinson Syndrome. A Case Report

Plummer-Vinson syndrome (PVS) is characterized by a triad of symptoms comprising microcytic hypochromic anemia, esophageal webs, and dysphagia. PVS is commonly found in women of middle age especially in the fourth and fifth decade of life and is rarely reported in males. We report a case of a 53-year-old female patient who had a classic presentation of PVS. PVS is precancerous with high malignant potential; early diagnosis is of utmost importance for better prognosis and surveillance endoscopy is recommended. Iron repletion oftentimes improves the dysphagia; seldom esophageal dilatation is used to provide symptomatic relief.

Epidemiology and Management of 144 Eclampsia Patients at Sikasso Hospital

Plummer Vinson syndrome is a rare condition characterized by cervical dysphagia associated with iron deficiency anemia and a ring on the upper esophagus. Sometimes its unusual presentation can lead to misdiagnosis. We report the observation of a patient with Plummer-Vinson syndrome, revealed by upper dysphagia.

Dysphagia in an Adolescent with Iron Deficiency Anemia.

Dysphagia in an Adolescent with Iron Deficiency Anemia.

Adam Brown Kelly and his operating chair.

Adam Brown Kelly, well known for lending his name to Paterson-Brown Kelly syndrome, is steeped in the early history of otolaryngology. To date, little light has been shone on his contributions to the specialty in that exciting period and to his home town of Glasgow. A historical review of his life and times was undertaken based on surviving accounts of his life, published work and archived memoirs. This article summarises his life and connections, with particular reference to his unique chair that has survived to this day. Brown Kelly remains a pioneer of modern otolaryngology, and deserving of prominence within the medical history of Glasgow.

"Plummer -Vinson Syndrome: Diagnosis by Barium Esophagogram Studies May Still Be Important in the Shortage of Endoscopic Sources"

Plummer-Vinson syndrome (PVS), association of iron deficiency with dysphagia due to proximal esophageal web, is still a relevant cause of dysphagia in Western societies as well as developing countries...

Síndrome de Plummer-Vinson en un paciente con enfermedad celíaca. Reporte de un caso

Plummer-Vinson syndrome is infrequent and is more common in middle-aged women. There are few reports of its association with celiac disease. Both entities can be linked to hypochromic anemia and esophageal carcinoma. We report the case of a 47-year-old female patient who, since the age of six, presented frequent episodes of iron deficiency anaemia, having required blood transfusions Eight months before the doctor’s appointment, when she swallowed a tablet, she presented a choking episode due to obstruction. Since then, she has been eating only soft foods. She had iron deficiency anemia, with low ferritin levels. A video swallow performed three months earlier showed a lack of fillong of 2 mm by 7 mm, which obliterated 75% of the esophageal lumen, and another similar image, 2 cm below the first one, arranged in the opposite direction, which obliterated the lumen by 50%. A video endoscopy was performed, which showed two membranes causing stenosis of the lumen in the cricopharyngeal region; they were removed. In the duodenal bulb and second portion, a flattened mucosa was observed, compatible with celiac disease. Biopsies were performed and the anatomopathological diagnosis was highly compatible with celiac disease, Marsh Oberhuber 3B. Conclusion. This observation demonstrates that celiac disease can coexist with Plummer Vinson syndrome. Therefore, it should be investigated in the context of this syndrome, with which it shares the relationship with iron deficiency anemia, and also taking into account the possibility of development of esophageal carcinoma in both entities.

ASSOCIATION OF IRON DEFICIENCY ANEMIAAND POST CRICOID WEBS – A PROSPECTIVE STUDY

Iron deciency anemia, post-cricoidal esophageal web and dysphagia are characteristics of Patterson Brown Kelly or Plummer-Vinson syndrome. Sideropenic dysphagia was coined by Waldenstorm. There has been a debate regarding the existence and frequency of esophageal webs in patients with iron deciency anemia.In, literature there is no study that correlates the severity of anemia and severity of the web or stricture.This is a prospective study of 50 patients over a period of 3 years. Through our study we would like to analyse if there is any corelationship especially in developing countries like ours were this study was conducted.

Anemia ferropénica crónica: síndrome de Plummer-Vinson (Paterson-Brown-Kelly)

Plummer-Vinson syndrome (Paterson-Brown-Kelly) is a rare entity, characterized by dysphagia, esophageal web formation, and iron deficiency anemia. We present the case of a 46-year-old woman with a clinical history of iron deficiency anemia who subsequently presents dysphagia and odynophagia. A subcricoid web that was successfully broken with the endoscope was found. First contact doctors should be familiar with the symptoms of Plummer-Vinson syndrome, and take them into account, when addressing a patient with the classic triad. Since the syndrome is a precancerous condition with high malignant potential, early diagnosis and treatment is of utmost importance for better prognosis. Keywords: Plummer-Vinson syndrome; chronic iron deficiency anemia; esophageal membrane; squamous cell esophageal cancer; Paterson-Brown-Kelly syndrome.

Plummer–Vinson syndrome

Plummer–Vinson syndrome (PVS) is characterized by a triad of postcricoid dysphagia, upper esophageal webs, and iron deficiency anemia, mostly affecting middle-aged females. A 30-year-old female patient presented to the gastroenterology outpatient department with complaints of dysphagia for solid foods for 1 year, which increased over the last 4 weeks. She had iron deficiency anemia. Barium swallow revealed a single thin esophageal web at the level of C4–5 vertebrae. Upper gastrointestinal endoscopy confirmed this. The patient was diagnosed with PVS. PVS is known to be associated with esophageal or pharyngeal cancers such as squamous cell carcinoma. Thus, we recommend early diagnosis of PVS and close follow-up of these patients.

Estimation of Iron and Ferritin Levels in Oral Submucousfibrosis (OSMF) Patients

Oral submucous fibrosis, with mucosal sensitivity to irritants such as areca nuts and chilly items due to chronic iron deficiency, is a form of sideropenic dysphagia. Serum iron is used for nutritional evaluation as a biochemical measure and serves as a predictor for the progression of the disease as there is a correlation between the quality of serum iron and oral carcinogenesis. Early diagnosis and prognosis can also be carried out by the assessment of biochemical parameters. The purpose of the research was to test OSMF patients with serum iron and ferritin. After prior consent, 50 participants were included in the study. They've been split into two classes. The research group consisted of 25 average, healthy individuals and a further 25 OSMF patients. 5 ml of blood was collected using a centrifuge and the serum was separated. Using the ERBA CHEM 5 plus analyser, serum iron was estimated using the Ferrozine/MgCO3 method and Ferritin by the Immunoturbidimetric Latex Assay methodIt was found that serum iron and serum ferritin levels decreased significantly compared to control levels in OSMF patients. In OSMF patients, serum iron was 84.29 ±19.3524.6419.35 compared to control 121.21 ± 19.35 and serum ferritin was77.14 ± 17.26 and 134.69 ±31.3 respectively. The current study concludes that serum iron and ferritin levels in OSMF patients are decreased relative to control levels that can be used to distinguish such patients as an indicator.