ABSTRACT
Introducción: El síndrome de Plummer-Vinson es una entidad rara caracterizada por la tríada anemia ferropénica, disfagia y membrana esofágica. Descrito en la segunda década del siglo pasado, en la actualidad la mayoría de los datos que se obtienen provienen de presentaciones de casos o pequeñas series de estudios prospectivos. Objetivo: Hacer la revisión de la bibliografía disponible a propósito de un caso portador de síndrome de Plummer-Vinson. Caso clínico: Paciente femenina de 35 años de edad con anemia desde la adolescencia remitida por presentar disfagia de 8 años de evolución. Se realizaron complementarios de laboratorio donde se constata anemia ferropénica y estudio contrastado del tracto digestivo superior que reveló imagen sugestiva de membrana en esófago cervical. Conclusiones: A pesar de su baja frecuencia en la actualidad debemos mantenernos alertas ante la aparición de síntomas sugestivos del síndrome de Plummer-Vinson fundamentalmente en mujeres con cuadros de anemia(AU)
Introduction: Plummer-Vinson syndrome is a rare entity characterized by the triad of iron deficiency anemia, dysphagia and esophageal membrane. Described in the second decade of the last century, today most of the data obtained comes from case presentations or small series of prospective studies. Objective: To review the available bibliography regarding a case with Plummer-Vinson syndrome. Clinical case: 35-year-old female patient with anemia since adolescence, referred to surgery clinic for presenting dysphagia of 8 years of evolution. Additional laboratory tests were carried out where iron deficiency anemia was found. A contrasted study of the upper digestive tract revealed a suggestive image of a membrane in the cervical esophagus. Conclusions: Despite its low frequency we must be alert to the appearance of symptoms suggestive of Plummer-Vinson syndrome, mainly in women with anemia. Its association with esophageal cancer indicates this(AU)
Subject(s)
Humans , Female , Adult , Deglutition Disorders/etiology , Plummer-Vinson Syndrome/diagnosis , Anemia, Iron-Deficiency/etiology , Ferrous Compounds/therapeutic use , Prospective Studies , Folic Acid/therapeutic useABSTRACT
Presentamos el caso de una paciente de sexo femenino de 40 años que consultó por astenia, adinamia, mareos y disnea progresiva de diez meses de evolución agregando en los últimos cuatro meses disfagia intermitente para sólidos. La radiografía esofágica con bario evidenció la presencia de una estenosis subcricoidea con buen pasaje distal y la videogastroscopía demostró inmediatamente por debajo del cricofaríngeo una membrana fibrosa estenosante. Se realizó tratamiento con hierro vía oral y reiteradas sesiones de dilatación con balón que lograron la resolución de los síntomas. El síndrome de Plummer-Vinson es una entidad poco frecuente caracterizada por la tríada anemia ferropénica, disfagia y membrana esofágica alta.
The study presents the case of a 40 year old female patient who consulted for asthenia, adynamia, dizziness and progressive dyspnea with 10 months of evolution, evidencing intermittent solid dysphagia in the last 4 months. Barium X-rays of the esophagus evidenced subcricoid stenosis with good distal passage and the gastroscopy immediately showed a stenosing fibrous membrane under the cricopharyngeal. Iron oral treatment was initiated and several sessions with a balloon catheter which solved the symptoms. Plummer-inson syndrome is a rare entity characterized by iron deficiency anemia, dysphagia and a high esophageal membrane.
Apresentamos o caso de uma paciente de sexo feminino de 40 anos que consultou por astenia, adinamia, tontura e dispneia progressiva com 10 meses de evolução e disfagia intermitente para sólidos nos últimos 4 meses. A radiografia esofágica com bário mostrou a presença de estenose abaixo da cartilagem cricoide com boa passagem distal e a endoscopia digestiva alta evidenciou membrana fibrosa estenosante logo abaixo do cricofaríngeo. Realizou-se tratamento com ferro por via oral e várias sessões de dilatação com balão com eliminação dos sintomas. A síndrome de Plummer-Vinson é uma doença rara caracterizada pela tríade ferropenia, disfagia e membrana esofágica alta.
Subject(s)
Humans , Plummer-Vinson Syndrome/diagnosis , Plummer-Vinson Syndrome/therapyABSTRACT
We report a case of Plummer-Vinson syndrome (PVS) and lower esophageal ring with a small sliding hiatal hernia. PVS is a rare entity formed by the combination of dysphagia, cervical esophageal web and iron deficiency anemia. It occurs mainly in middle-aged women1,2,3. A lower esophageal ring and a small sliding hiatal hernia were also observed in this case. We documented clinical manifestations of iron deficiency anemia through images and esophageal abnormalities through barium esophagogram. (AU)
Subject(s)
Humans , Female , Adult , Plummer-Vinson Syndrome/blood , Plummer-Vinson Syndrome/diagnostic imaging , Esophageal Sphincter, Lower/diagnostic imaging , Hernia, Hiatal/diagnostic imaging , Anemia, Iron-Deficiency/bloodABSTRACT
A síndrome de Plummer-Vinson é uma condição rara, caracterizada pela presença de anemia ferropriva, disfagia cervical e membranas esofágicas. É mais prevalente em mulheres de 40 a 70 anos, de países escandinavos e anglo-saxônicos, de etiologia incerta, contudo há duas teorias que podem ser relacionadas à síndrome: a teoria da deficiência de ferro e a teoria da disfagia primária. Adeficiência em ferro pode provocar mudanças no trato digestório superior, provocan do anemia hipocrômica e microcítica. Já a disfagia colabora com a mudança dos hábitos alimentares dos pacientes, o que resulta em deficiência de ferro e outras vitaminas. Mesmo rara, a Síndrome de Plummer-Vinson necessita ser lembrada durante a formulação de hipóteses diagnósticas, visto que está relacionada como fator de risco para carcinomas espinocelulares do trato gastrointestinal superior.
The Plummer-Vinson syndrome is a rare condition characterized by the presence of iron deficiency anemia, cervical dysphagia and esophageal membranes. It is more prevalent in women aged 40-70 from Scandinavian and Anglo-Saxon countries, and is of unknown etiology, but there are two theories that can be related to the syndrome: the iron deficiency theory and the theory of primary dysphagia. Iron deficiency can cause changes in the upper digestive tract, causing hypochromic and microcytic anemia. Existing dysphagia combines with the changing eating habits of patients, resulting in deficiency in iron and other vitamins. Although rare, Plummer-Vinson syndrome needs to be remembered during the formulation of diagnostic hypotheses, since it is listed as a risk fator for squamous cell carcinoma of the upper gastrointestinal tract.
Subject(s)
Humans , Male , Aged , Deglutition Disorders , Plummer-Vinson SyndromeABSTRACT
Plummer-Vinson syndrome manifests as cervical dysphagia, iron deficiency anemia, an upper esophageal web, and atrophic glossitis. The cause of the esophageal web is thought to be iron deficiency anemia; however, the cause of Plummer-Vinson syndrome has not been established. Crohn's disease is usually accompanied by malnutrition and iron deficiency anemia; however, no case of concomitant Crohn's disease and Plummer-Vinson syndrome with aggravated malnutrition and anemia has been previously reported. Here, we report on a rare case of Plummer-Vinson syndrome in a Crohn's disease patient, which caused malnutrition and constipation.
Subject(s)
Adult , Humans , Male , Cobblestone Lissencephaly/diagnosis , Colon, Sigmoid/surgery , Crohn Disease/complications , Esophageal Sphincter, Upper/diagnostic imaging , Plummer-Vinson Syndrome/diagnosis , Sigmoidoscopy , Sphincterotomy, Endoscopic , Tomography, X-Ray ComputedABSTRACT
Plummer-Vinson syndrome is characterized by dysphagia, iron deficiency anemia, and upper esophageal web. The associated symptoms can be resolved by administering iron supplements as well as by endoscopic intervention. Relapse in patients with Plummer-Vinson syndrome is very rare. We describe a case of a 42-year-old woman with Plummer-Vinson syndrome whose symptoms were successfully treated with endoscopic dilatation and iron supplementation at first admission; however, 1 year later, she revisited our hospital because of dysphagia. On second admission, investigations revealed esophageal web relapse in Plummer-Vinson syndrome. She was again successfully treated with endoscopic dilatation and iron supplementation. After first admission, her anemia was not normalized due to poor compliance and loss of follow-up. We experienced a case of esophageal web relapse due to uncorrected iron deficiency anemia in a patient with Plummer-Vinson syndrome. This experience indicates that continuous iron supplementation and long-term follow-up is important in patients with Plummer-Vinson syndrome.
Subject(s)
Adult , Female , Humans , Anemia , Anemia, Iron-Deficiency , Compliance , Deglutition Disorders , Dilatation , Follow-Up Studies , Iron , Plummer-Vinson Syndrome , RecurrenceABSTRACT
Plummer-Vinson syndrome is characterized by dysphagia, iron deficiency anemia, and upper esophageal web. The associated symptoms can be resolved by administering iron supplements as well as by endoscopic intervention. Relapse in patients with Plummer-Vinson syndrome is very rare. We describe a case of a 42-year-old woman with Plummer-Vinson syndrome whose symptoms were successfully treated with endoscopic dilatation and iron supplementation at first admission; however, 1 year later, she revisited our hospital because of dysphagia. On second admission, investigations revealed esophageal web relapse in Plummer-Vinson syndrome. She was again successfully treated with endoscopic dilatation and iron supplementation. After first admission, her anemia was not normalized due to poor compliance and loss of follow-up. We experienced a case of esophageal web relapse due to uncorrected iron deficiency anemia in a patient with Plummer-Vinson syndrome. This experience indicates that continuous iron supplementation and long-term follow-up is important in patients with Plummer-Vinson syndrome.
Subject(s)
Adult , Female , Humans , Anemia , Anemia, Iron-Deficiency , Compliance , Deglutition Disorders , Dilatation , Follow-Up Studies , Iron , Plummer-Vinson Syndrome , RecurrenceABSTRACT
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.
Subject(s)
Adult , Female , Humans , Plummer-Vinson Syndrome , Plummer-Vinson Syndrome/diagnosisABSTRACT
Presentamos a una mujer de 39 años que acude a nuestro hospital por disnea de esfuerzo, adinamia y cansancio progresivo desde hace 8 meses. Antecedente quirúrgico de miomectomia por menometrorragias frecuentes. Niega ser vegetariana. Régimen catamenial: 3-5 días cada mes. Hace 2 meses se añade ôardorõ en lengua al comer. Nota uñas quebradizas. Toleraba alimentos blandos. Al examen físico había moderada palidez; las uñas eran muy delgadas, frágiles y algo cóncavas. En la boca se encontró estomatitis angular, lengua depapilada y glositis. El diagnóstico clínico era síndrome anémico y disfagia. Exámenes auxiliares: Hb: 7.0g/dL; VCM: 57.42fL; HCM: 15.82pg; leucocitos: 4,980; reticulocitos: 2.18%, índice reticulocitario: 0.1%, hierro sérico: 21ug/dl, transferrina (TIBC): 286, saturación de transferrina: 7%, ferritina sérica: 27ng/ml. La lámina periférica demostró anisocitosis, hipocromía y microcitosis. Thevenon en heces negativo. Ecografía abdominal: mioma uterino. La radiografía esofágica con bario demostró una imagen lineal por defecto de relleno de 2 mm a altura entre vértebras C4 y C5 en vista anteroposterior y lateral; se extendía a cara anterior y reducía la luz esofágica en 60%. Durante la endoscopía, evidenciamos una membrana fibrosa estenosante en la región cricofaríngea. Multiples dilataciones fueron realizadas progresivamente mediante una guía con bujías dilatadoras Savary-Gilliard hasta 14 mm, mejorando la disfagia. Recibió terapia transfusional y hierro parenteral. Salió de alta con sulfato ferroso y ácido fólico. El síndrome de Plummer-Vinson, Paterson-Brown-Kelly o disfagia sideropénica es definido por disfagia, anemia ferropénica y membrana esofágica alta. El síndrome es descrito como muy raro.
A 39-year-old woman was admitted to our hospital with an eight-month history of dyspnea on exertion, weakness and increasing fatigue. She reported repeated episodes of menome trorrhsgis snd underwent a myomectomy. She is not a vegetarian. Her menstrual bleeding: 3-5 days per month. Two months ago, she complained of burning sensation of the tonge upon swallowing food and noted brittle nails. She tolerated soft foods. On physical examination, she was pale; her nails were very thin, fragile and somewhat concave. Her oral examination showed angular stomatitis, depapillated togue and glossitis. The clinical diagnosis was anemia and dysphagia. Laboratory tests were: Hb: 7.0g/dL, MCV: 57.42fL, MCH: 15.82 pg; leukocytes:4,980; reticulocytes:2.18%, reticulocyte index:0.1%, serum iron:21ug/dl, total iron binding capacity (TIBC):286, transferrin saturation: 7% and serum ferritin: 27ng/ml. The peripheral blood smear showed anisocytosis and hypochromic microcytic cells. Thevenon test was negative. Abdominal ultrasound: uterine myoma. A barium swallow X-ray showed a 2-mm linear filling defect between the 4th and 5th cervical vertebrae in the anteroposterior and lateral view; it protruded from the anterior wall and reduced esophageal lumen by 60%. In the endoscopy, we found a fibrous web in the cricopharyngeal area. Serial dilatations were performed over a guidewire using Savary-Gilliard dilators with diameter up to 14 mm, improving dysphagia. She was treated with transfusional therapy and parenteral iron. She was discharged with ferrous sulfate and folic acid. The Plummer-Vinson syndrome, Paterson-Brown-Kelly or sideropenic dysphagia is characterized by dysphagia, iron-deficiency anemia and upper esophaegal web. The syndrome is described as very rare.
Subject(s)
Humans , Adult , Female , Anemia, Iron-Deficiency , Esophageal Spasm, Diffuse , Plummer-Vinson Syndrome/diagnosis , Deglutition DisordersABSTRACT
A síndrome de Plummer-Vinson ou Patterson-Kelly é doença rara caracterizada pela tríade disfagia intermitente, ferropenia e membrana esofágica. São poucos os dados na literatura sobre sua prevalência. Embora seja atualmente uma síndrome rara, seu reconhecimento é importante, pois identifica um fator de risco para câncer de trato gastrointestinal alto. Aqui descrevemos um caso desta síndrome com revisão de literatura
Subject(s)
Aged , Anemia, Iron-Deficiency , Deglutition Disorders , Plummer-Vinson SyndromeSubject(s)
Humans , Child , Adult , Deglutition , Deglutition Disorders , Electromyography , Gastroesophageal Reflux , Laryngoscopy , Manometry , Oral Stage , Pharyngeal Muscles , Pulmonary Disease, Chronic Obstructive , Central Nervous System , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/diagnosis , Myasthenia Gravis , Myositis , Peripheral Nervous System , Plummer-Vinson Syndrome , Zenker DiverticulumABSTRACT
Plummer-Vinson syndrome is a complex syndrome characterized by upper esophageal webs, dysphagia, and iron deficiency anemia. This syndrome develops principally in middle-aged women, and only rarely in patients over age 80. We present a case of Plummer-Vinson syndrome occurring in an 82-year-old woman who visited the hospital because of progressive dysphagia. Esophagogram and endoscopic examination showed an upper esophageal web, and laboratory examination revealed iron deficiency anemia. Dysphagia improved after endoscopic balloon dilatation, and iron deficiency anemia improved after iron supplementation. Even Plummer-Vinson syndrome can be improved by sufficient amounts of oral ferrous sulfate and endoscopic balloon dilatation, it is important to identify the cause of iron deficiency anemia and to check for the presence of malignant disease. The common causes of anemia differ between middle-aged and elderly women, and the clinician needs to look for malignancy-induced chronic gastrointestinal tract blood loss and chronic inflammatory diseases. We report a rare case of Plummer- Vinson syndrome in a woman over 80 years of age.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Anemia , Anemia, Iron-Deficiency , Deglutition Disorders , Dilatation , Ferrous Compounds , Gastrointestinal Tract , Iron , Plummer-Vinson SyndromeABSTRACT
A síndrome de Plummer-Vinson é caracterizada por disfagia cervical, deficiência de ferro e presença de membrana esofágica. Neste estudo, relatam-se dois casos dessa síndrome em irmãos adolescentes. Eles não obtiveram aumento dos níveis hematimétricos após reposição com ferro oral, o que, associado à eletroforese de hemoglobinas, sustentou o diagnóstico de talassemia concomitante. Devido ao quadro dos filhos, os pais foram também submetidos à eletroforese de hemoglobinas cujo diagnóstico do pai foi talassemia alfa/beta menor e da mãe, talassemia alfa menor. Os irmãos tiveram disfagia refratária e necessitaram de dilatação endoscópica. Ambos necessitaram de terapia com ferro venoso com melhora dos níveis hematimétricos.
Plummer-Vinson syndrome is characterized by cervical dysphagia, iron deficiency and the presence of esophageal membranes. We report two cases of this syndrome present in adolescent brothers with associated thalassemia. After oral iron therapy, their hematimetric levels showed no increase, which associated with the results of hemoglobin electrophoresis, sustained the diagnosis of thalassemia. Due to the condition of the children, the parents were submitted to hemoglobin electrophoresis examinations; the father was diagnosed as having minor alpha/beta thalassemia and the mother as minor beta thalassemia. Both patients suffered from refractory dysphagia and required endoscopic dilatation. They both underwent venous iron therapy, which improved the hematimetric levels.
Subject(s)
Plummer-Vinson Syndrome , Thalassemia , Deglutition Disorders , Anemia, Iron-DeficiencySubject(s)
Adult , Deglutition Disorders/diagnosis , Female , Humans , Plummer-Vinson Syndrome/diagnosisABSTRACT
Introdução: A síndrome de Plummer - Vinson, também conhecida como Síndrome de Patterson Kelly, écaracterizada pela presença de membranas esofágicas apresentando-se, como descrito nos quatro casos, deformas variadas, mas tendo como principal característica a disfagia conseqüente da presença de anéis esofágicos mais comumente no esôfago superior. Objetivos: Relatar quatro casos da Síndrome de Plummer-Vinson com apresentações clínicas diversasdiagnosticados no Serviço de gastroenterologia do Hospital São José de Criciúma-SC e discutir os principaistópicos da abordagem diagnóstica e terapêutica dessa enfermidade. Métodos: Os casos foram relatados com base nos prontuários médicos dos pacientes obtidos nos arquivos do Hospital São José de Criciúma-SC com diagnóstico de Síndrome de Plummer-Vinson. Discussão: Os autores discutem os principais pontos a respeito do quadro clínico, diagnóstico e tratamentodos pacientes com o diagnóstico de Síndrome de Plummer-Vinson.
Introduction: The Plummer-Vinson´s Syndrome, also known as Patterson Kelly´s Syndrome, is caracterized by esophageal membranes presence, asdescribed in the four cases in varied ways, but having as main characteristic a dysphagia coming from esophageal rings presence more common in the upper part of the esophagus. Objectives: To present four Plummer-Vinson´sSyndrome cases with several clinical presentations diagnosed at the Gastroenterology Department at SãoJosé Hospital in Criciúma-SC, and discuss the man topics of the therapeutic and diagnostic approach of such illness.Methods: The cases were presented based on the patientsæ medical record had in the files of São José Hospital, Criciúma-SC, with Plummer-Vinson´ssyndrome diagnosis. Discussion: The researchers discuss about the mainpoints concercining the clinical finding diagnosis and the patientesæ treatment with the Plummer-Vinsonæs syndromediagnosis.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged, 80 and over , Deglutition Disorders , Plummer-Vinson SyndromeABSTRACT
The Study was conducted at Combined Military Hospital Rawalpindi, to identify cases of dysphagia in both genders, to see sex predominance, to find the aetiology in our population and to compare it with the literature. Study was conducted on 54 cases of dysphagia 32 male and 22 female, from outpatient department of CMH Rawalpindi. 31.45% were cases of foreign body esophagus, 16.66% were case of Carcinoma esophagus, 9.25% were of leiomyoma esophagus, 11.11% were of Carcinoma pyriform fossa hypopharynx, 7.40% were of peptic stricture esophagus, 3.7% were of globus pharyngeus, 3.7% were of Plummer Vinsons disease, 1.85% of Zenker's Diverticulum. All the esophageal pathologies have equal sex involvement. 14.81% were of postcricoid carcinoma female predominance. Our results were compared with the literature. Some esophageal pathology values were matched with the results and some were contrary what we saw in the literature
Subject(s)
Humans , Male , Female , Deglutition Disorders/epidemiology , Incidence , Adult , Foreign Bodies , Esophagus/pathology , Esophageal Neoplasms , Leiomyoma , Esophageal Stenosis , Plummer-Vinson Syndrome , Zenker DiverticulumABSTRACT
The association of Paterson Brown Kelly Syndrome and celiac disease is not widely reported. Both the entities have iron deficiency anemia. This case report emphasizes the need of screening for celiac disease in patients with Paterson Kelly Syndrome.
Subject(s)
Adult , Anemia, Iron-Deficiency/physiopathology , Celiac Disease/diagnosis , Diagnosis, Differential , Duodenum/pathology , Female , Humans , Intestinal Mucosa/pathology , Plummer-Vinson Syndrome/diagnosisABSTRACT
A presença de membrana esofágica adquirida, na área pós-cricóide, associada ou não com anemia ferropriva é denominada síndrome de Plummer-Vinson ou de Patterson-Kelly. A disfagia associada a SPV é tipicamente intermitente e limitada aos alimentos sólidos. Os enfermos podem apresentar queixa de engasgo ou até episódios aspirativos. A patogênese da síndrome envolve a deficiência nutricional com dieta deficiente em frutas frescas, vegetais e carnes. A presença de membranas esofágicas é associada ao risco elevado de câncer esofágico ou faríngeo, com necessidade de endoscopia digestiva alta periódica para a detecção de alterações pré-neoplásicas na faringe ou no esôfago. Os autores descrevem doente portadora de síndrome de Plummer-Vinson com disfagia para alimentos sólidos, anemia ferropriva, carência nutricional crônica e membranas na luz do esôfago cervical. O tratamento habitual é a reposição oral ou parenteral de ferro associada à dilatação esofágica e/ou rompimento da membrana do esôfago por via endoscópica e à correção das deficiências nutricionais. Essa terapêutica foi adotada com sucesso na enferma desse relato que, após seis meses de seguimento, permanece assintomática, alimentando-se adequadamente, sem perda ponderal ou anemia.