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Asaad A, Jamal R. A Case of Plummer-Vinson Syndrome in an Omani Woman. Cureus 2023; 15:e41050. [PMID: 37519547 PMCID: PMC10374335 DOI: 10.7759/cureus.41050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Plummer-Vinson syndrome (PVS) is the triad of iron-deficiency anemia, esophageal webs and dysphagia. This article discusses the first reported case of PVS from Oman. A female patient in her 40s presented with a one-year history of dysphagia and odynophagia and a known background of untreated iron-deficiency anemia. After an elaborate workup, a diagnosis of PVS was made following visualization of the esophageal web with barium swallow study and esophagogastroduodenoscopy (EGD). A prompt and accurate diagnosis of PVS, although rare, is crucial, given that it is, at times, a precancerous condition. The treatment with iron therapy is the cornerstone of management, and it corrects the anemia as well as the dysphagia. If dysphagia persists, endoscopic dilation can be carried out.
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Affiliation(s)
- Alhasan Asaad
- Department of Internal Medicine, National University of Science and Technology, Muscat, OMN
| | - Rama Jamal
- Department of Internal Medicine, National University of Science and Technology, Muscat, OMN
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Patil G, Vadgaonkar A, Dalal A, Parekh S, Shah A, Haridas P, Gupte P, Vora S, Maydeo A. Endoscopic Submucosal Dissection for Esophageal Squamous Cell High-grade Dysplasia in a Patient with Plummer Vinson Syndrome. JOURNAL OF DIGESTIVE ENDOSCOPY 2022. [DOI: 10.1055/s-0042-1759510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
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.
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Affiliation(s)
- Gaurav Patil
- Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
| | - Amol Vadgaonkar
- Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
| | - Ankit Dalal
- Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
| | - Sanil Parekh
- Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
| | - Animesh Shah
- Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
| | - Poorva Haridas
- Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
| | - Prajakta Gupte
- Department of Pathology, HBT Medical College and Dr. R N Cooper Hospital, Mumbai, Maharashtra, India
| | - Sehajad Vora
- Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
| | - Amit Maydeo
- Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
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Chaudhry IUH, AlFraih OM, A AlAbdulhai M, Al Qahtani Y, Al Maimon H, Ali H, A Al Haddad A, Alghamdi AM. Dysphagia in a patient with Plumer Vinson syndrome: An innovative surgical dilatation technique after failed endoscopy. Ann Med Surg (Lond) 2022; 78:103865. [PMID: 35734748 PMCID: PMC9207060 DOI: 10.1016/j.amsu.2022.103865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/21/2022] [Accepted: 05/22/2022] [Indexed: 12/02/2022] Open
Abstract
For the last five years, a 43-year-old female presented with progressive dysphagia for solids and liquids. She was treated for iron deficiency anemia by systemic and oral iron therapy. Gastroenterologists failed to pass endoscopes through the upper esophagus. Gastrogrifin swallow revealed a critical narrowing of the esophagus. She was referred to a thoracic surgeon for further management. The cervical esophagus was exposed through the neck incision along the anterior border of the left sternocleidomastoid muscle, and esophageal dilatation was achieved using the silicon foleys catheter. It is a very safe and valuable surgical technique when dysphagia cannot be managed by endoscopically. A 43 years old female know case of iron deficiency anemia. Oral and intravenous iron replacements for two years. Failed endoscopy examination due to unable to pass endoscope through esophagus. Innovative surgical dilatation technique using foleys catheter.
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GÖKÇE A, UYANIKOĞLU A, DİKEÇ B. Plummer-Vinson syndrome presenting with dysphagia. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.928677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Plummer-Vinson sendromu (PVS), disfaji, demir eksikliği anemisi ve özofagusta veb ile karakterize nadir görülen bir sendromdur. Katı ve sıvı gıdaları yutma güçlüğü, halsizlik, yorgunluk, bulantı, kusma, kilo kaybı şikayetleri ile polikliniğimize başvuran, PVS teşhisi konulan, gastroskopik balon dilatasyonu yapılan ileri yaş kadın hasta ve PVS ile ilgili kısa bir derleme sunulmuştur.
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Obeidat AE, So S, Go J, Murakami TT. The Missing Link: A Case of Plummer-Vinson Syndrome in a Young Pacific-Islander Woman With Helicobacter Pylori. Cureus 2021; 13:e18934. [PMID: 34812318 PMCID: PMC8604426 DOI: 10.7759/cureus.18934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/06/2022] Open
Abstract
Plummer-Vinson syndrome (PVS), the triad of dysphagia, iron-deficiency anemia (IDA), and esophageal webs, is a relatively rare disease entity that is mostly observed in the Caucasian populations of Scandinavia and North America. As these regions have become more developed with improved nutrition, PVS is now more commonly seen in the developing regions of the world. We present the case of a 29-year-old Pacific-islander woman who presented with progressive dysphagia and IDA and was found to have an esophageal web and Helicobacter pylori (H. pylori) gastritis on upper endoscopy. She improved with dilation of the web in the esophagus and treatment of H. pylori. Identifying the possibility of this syndrome in clinical practice and the association between H. pylori and PVS, especially given recent changes in its epidemiology, is important given the patient population in Hawaii and the Pacific.
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Affiliation(s)
| | - Shirley So
- Internal Medicine, California Pacific Medical Center, San Francisco, USA
| | - Joseph Go
- Internal Medicine, University of Hawaii, Honolulu, USA
| | - Traci T Murakami
- Department of Gastroenterology and Hepatology, The Queen's Medical Center West Oahu, Ewa Beach, USA
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Harmouch F, Liaquat H, Chaput KJ, Geme B. Plummer-Vinson Syndrome: A Rare Cause of Dysphagia in an Octogenarian. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929899. [PMID: 33895769 PMCID: PMC8083793 DOI: 10.12659/ajcr.929899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Patient: Female, 88-year-old Final Diagnosis: Esophageal web • iron deficiency • Plummer-Vinson syndrome Symptoms: Dysphagia Medication:— Clinical Procedure: Esophagogastroduodenoscopy Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- Farah Harmouch
- Department of Internal Medicine, St. Luke's University Hospital Health Network, Bethlehem, PA, USA
| | - Hammad Liaquat
- Department of Gastroenterology, St. Luke's University Hospital Health Network, Bethlehem, PA, USA
| | - Kimberly J Chaput
- Department of Gastroenterology, St. Luke's University Hospital Health Network, Bethlehem, PA, USA
| | - Berhanu Geme
- Department of Gastroenterology, St. Luke's University Hospital Health Network, Bethlehem, PA, USA
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Patil M, Malipatel R, Devarbhavi H. Plummer-Vinson syndrome: A decade's experience of 132 cases from a single center. J Gastroenterol Hepatol 2021; 36:181-185. [PMID: 32525241 DOI: 10.1111/jgh.15139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/27/2020] [Accepted: 06/06/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIM Plummer-Vinson syndrome (PVS) comprises triad of iron deficiency anemia, dysphagia, and post-cricoid esophageal web. PVS is rare nowadays due to improved nutritional status. However, we encountered patients with PVS regularly at our center. Data regarding PVS are limited; hence, we aimed to study the clinical features, treatment outcomes, and development of complications in patients with PVS. METHODS The study was conducted over a 10-year period (January 2008 to January 2018) in a medical college setting. All adults with dysphagia, anemia, and post-cricoid web or those with iron deficiency anemia and post-cricoids web were included in the study. Patients were treated with iron supplementation and Savary-Gilliard bougie dilation of the web. Patients were followed-up for the recurrence of dysphagia and development of complications. RESULTS Overall, 153 patients exhibited esophageal web, of which 132 (86.27%) patients had concomitant PVS and 21 (13.7%) patients did not. The mean age was 43.50 years (range 16-76) and 113 (85.6%) were women. Single session of Savary-Gilliard bougie dilation was successful in 90.7% of patients in relieving dysphagia and 9.3% developed recurrence, requiring repeated dilations. Four patients had concomitant squamous cell carcinoma of esophagus along with PVS and two developed upper gastrointestinal malignancy during follow-up. CONCLUSION Plummer-Vinson syndrome is predominantly seen in middle aged women and present with symptoms of iron deficiency anemia and early grade dysphagia. Single session of Savary-Gilliard bougie dilation was successful in majority of patients in relieving dysphagia. Overall risk of developing upper gastrointestinal malignancy was 4.5%.
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Affiliation(s)
- Mallikarjun Patil
- Department of Gastroenterology, St. John's Medical College Hospital, Bangalore, India
| | - Renuka Malipatel
- Department of Pathology, St. John's Medical College Hospital, Bangalore, India
| | - Harshad Devarbhavi
- Department of Gastroenterology, St. John's Medical College Hospital, Bangalore, India
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Kyriakos N, Papaefthymiou A, Giakoumis M, Papadomichelakis M, Liatsos C. Plummer-Vinson Syndrome in a Crohn's disease patient. Arab J Gastroenterol 2020; 21:59-61. [PMID: 32088165 DOI: 10.1016/j.ajg.2020.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 01/11/2020] [Accepted: 01/26/2020] [Indexed: 11/16/2022]
Abstract
Plummer Vinson Syndrome (PVS), a rare condition complicating iron deficiency anaemia, manifests as a classic triad of dysphagia, anaemia and oesophageal web. Iron deficiency is the commonest systematic complication of Crohn's disease with only one described case of a Crohn's disease patient combined with PVS in the literature. We present a case of PVS complicating Crohn's disease in a 38-years-old female patient under treatment with the biologic agent Ustekinumab (human interleukin 12/23 monoclonal antibody) suffering from a progressively worsening dysphagia.
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Affiliation(s)
- Nikolaos Kyriakos
- Department of Gastroenterology, 401 General Military Hospital of Athens, Athens 11525, Greece
| | - Apostolis Papaefthymiou
- Department of Gastroenterology, 401 General Military Hospital of Athens, Athens 11525, Greece
| | - Marios Giakoumis
- Department of Gastroenterology, 401 General Military Hospital of Athens, Athens 11525, Greece
| | | | - Christos Liatsos
- Department of Gastroenterology, 401 General Military Hospital of Athens, Athens 11525, Greece.
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Kchir H, Hassine A, Gharbi O, Ridene I, Maamouri N. [A rare cause of dysphagia: Plummer Vinson syndrome associated with arteria lusoria]. Presse Med 2019; 48:1582-1584. [PMID: 31703955 DOI: 10.1016/j.lpm.2019.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 06/12/2019] [Accepted: 08/27/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Hela Kchir
- Hôpital La Rabta, service de gastroentérologie B, Tunis, Tunisie.
| | - Amira Hassine
- Hôpital La Rabta, service de gastroentérologie B, Tunis, Tunisie
| | - Ons Gharbi
- Hôpital La Rabta, service de gastroentérologie B, Tunis, Tunisie
| | - Imene Ridene
- Hôpital Mahmoud El Matri, service de radiologie, Ariana, Tunisie
| | - Nadia Maamouri
- Hôpital La Rabta, service de gastroentérologie B, Tunis, Tunisie
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Lo KB, Albano J, Sandhu N, Candelario N. Plummer-Vinson syndrome: improving outcomes with a multidisciplinary approach. J Multidiscip Healthc 2019; 12:471-477. [PMID: 31417270 PMCID: PMC6593774 DOI: 10.2147/jmdh.s180410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/20/2019] [Indexed: 12/29/2022] Open
Abstract
Plummer-Vinson syndrome is a rare condition associated with dysphagia, iron deficiency, and esophageal webs. Data regarding this condition is limited to mostly case reports and a few small cohort studies. Although most cases have a benign and indolent course, the risk of malignancy warrants long-term surveillance. A multidisciplinary approach among healthcare providers is of the utmost importance in the management of this condition.
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Affiliation(s)
- Kevin Bryan Lo
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Jeri Albano
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Naemat Sandhu
- Department of Gastroenterology and Hepatology, Einstein Medical Center, Philadelphia, PA, USA
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Goel A, Bakshi SS, Soni N, Chhavi N. Iron deficiency anemia and Plummer-Vinson syndrome: current insights. J Blood Med 2017; 8:175-184. [PMID: 29089792 PMCID: PMC5655134 DOI: 10.2147/jbm.s127801] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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.
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Affiliation(s)
- Amit Goel
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Satvinder Singh Bakshi
- Department of Otorhinolaryngology and Head and Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Neetu Soni
- Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Nanda Chhavi
- Department of Pediatrics, Era's Lucknow Medical College, Lucknow, India
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Long-term evolution of squamous-cell cancer in Plummer-Vinson syndrome. GASTROENTEROLOGY REVIEW 2017; 12:226-228. [PMID: 29123586 PMCID: PMC5672712 DOI: 10.5114/pg.2017.70477] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 10/29/2016] [Indexed: 11/17/2022]
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