Plummer-Vinson
Syndrome
PlummerVinson syndrome (also termed Paterson Kelly syndrome) is an
uncommon disorder manifested by a constellation of findings, including iron
deficiency anemia and proximal cervical esophageal webs. It is most typically
found in middleaged women. The precise relationship of the webs to the anemia
is unclear. The chief characteristic of PlummerVinson syndrome is dysphagia,
which is often accompanied by hypochromic anemia.
The patient’s chief complaints are
invariably difficulty in swallowing, usually accompanied by generalized
weakness due to anemia, and dryness of the mouth with burning of the
tongue. The syndrome develops gradually over a period of several months or even
years and leads to a sensation of obstruction in the back of the throat and
neck. Fluids are in almost all cases well tolerated, whereas solid food may be
rejected or impossible to swallow.
Atrophic glossitis and a dry
pharyngeal and buccal mucosa, with painful cracks at the angles of the mouth,
are present regularly in all patients suffering from this syndrome. The
atrophic mucosa may extend into the hypopharynx and into the mouth of the
esophagus. Less common are the brittle fingernails and other evidence of
multiple avitaminosis.
Older case reports have
demonstrated resolution of the webs with correction of the iron deficiency and
recurrence without correction. Treatment is generally dilation or endoscopic
incision of the web and correction of the iron deficiency anemia.
