Iron deficiency anemia and Plummer–Vinson syndrome: current insights

Abstract

Plummer–Vinson syndrome (PVS), a rare clinical condition, is characterized by a triad of dysphagia, iron deficiency anemia and esophageal web in the post-cricoid region. It was first described over a century ago. However, literature on this condition remains scanty, and its prevalence appears to be declining worldwide, possibly due to improvements in nutrition over time. The condition has been reported most commonly in thin-built, middle-aged, white women. The esophageal webs in PVS are thin mucosal folds, which are best seen either in lateral views at barium swallow or at esophagoscopy. These are usually semilunar or crescentic, being located most often along the anterior esophageal wall, but can be concentric. The exact cause and pathogenesis of PVS remain unclear, though iron and other nutritional deficiencies, genetic predisposition and autoimmunity have all been implicated in formation of the webs. Treatment includes correction of iron deficiency and endoscopic dilation of the esophageal webs to relieve dysphagia. PVS is associated with an increased risk of hypopharyngeal and esophageal malignancies. Correction of iron deficiency may arrest and reverse the mucosal changes and possibly reduces this risk.

Manifestaciones orales de trastornos hematológicos no neoplásicos

“…Es una condición clínica rara que se caracteriza por la triada de disfagia, presencia de membranas esofágicas y anemia ferropénica crónica. 3,16 Los factores relacionados con su etiología son la anemia ferropénica, desnutrición, predisposición genética, procesos autoinmunes y otras deficiencias de nutrientes (piridoxina o la riboflavina). 16,17 Se ha reportado en todas partes del mundo y comúnmente se presenta en mujeres blancas de complexión delgada durante la mediana edad.…”

“…3,16 Los factores relacionados con su etiología son la anemia ferropénica, desnutrición, predisposición genética, procesos autoinmunes y otras deficiencias de nutrientes (piridoxina o la riboflavina). 16,17 Se ha reportado en todas partes del mundo y comúnmente se presenta en mujeres blancas de complexión delgada durante la mediana edad. 16 Las manifestaciones orales son atrofia de la mucosa del esófago con formación de membranas que provocan disfagia (síntoma común), pero también puede presentar glositis atrófica, queilitis angular y glosodinia.…”

Iron and Iron Deficiency Anemia - A Review

“…Dysphagia (difficulty in swallowing), glossitis, angular stomatitis, and esophageal webs in the post cricoid region are associated with PVS [46]. Treating iron deficiency may reverse the mucosal changes [47]. Koilonchyia is the spoon-shaped (concave) nails caused by IDA.…”

A Rare Case of Plummer-Vinson Syndrome

“…Chronic irritation of the esophagus may predispose to an increased risk of developing esophageal webs or strictures. Common complications of PVS include hypopharyngeal cancer, esophageal cancer, and oral cancer [5]. Some differential diagnosis of PVS considered is dysphagia from achalasia, reflux esophagitis, esophageal carcinoma, esophageal spasm, systemic sclerosis, and Zenker's diverticulum [5].…”

“…Common complications of PVS include hypopharyngeal cancer, esophageal cancer, and oral cancer [5]. Some differential diagnosis of PVS considered is dysphagia from achalasia, reflux esophagitis, esophageal carcinoma, esophageal spasm, systemic sclerosis, and Zenker's diverticulum [5]. Physical examination of patients with PVS is usually remarkable for pallor, glossitis, fatigue, and weakness [6].…”