Plummer-Vinson syndrome, also known as Paterson-Kelly syndrome or sideropenic dysphagia, is characterized by iron deficiency anemia, dysphagia, and glossitis. It predominantly affects Caucasian women aged 30 to 50, is less common in men, and is rare among Chinese individuals.

bubble_chart Etiology

Iron deficiency is the most fundamental cause of this condition, commonly seen in those with poor dietary habits. However, since not all patients with iron-deficiency anemia experience dysphagia, iron deficiency is not the sole cause. It may also be related to factors such as B vitamin deficiency, constitution, race, and family history.

bubble_chart Pathological Changes

Mainly atrophy of the pharyngeal and upper esophageal mucosa. The underlying muscles show atrophy and degeneration, with mucosal folds.

bubble_chart Clinical Manifestations

The main clinical manifestations include dysphagia and a sensation of a foreign body in the throat. The dysphagia is intermittent, painless, and often progresses to become persistent. Symptoms of iron deficiency anemia are commonly observed, such as loss of appetite, lack of strength, palpitation, pallor, spoon-shaped nails (koilonychia), and alopecia areata. Additionally, angular stomatitis, glossitis, and a smooth, atrophic tongue with loss of papillae are frequently present. In most patients, X-ray and esophagoscopy reveal a membranous web in the hypopharynx or upper esophagus. Laboratory tests almost invariably show iron deficiency anemia, with significantly reduced serum iron levels, and some cases may exhibit pernicious anemia.

bubble_chart Diagnosis

1. Clinical manifestations include iron deficiency anemia, dysphagia, and glossitis.

2. Barium meal esophagography or esophagoscopy reveals a membranous-like mucosal fold at the upper end of the lower esophagus.

bubble_chart Treatment Measures

The main treatment involves correcting iron and B-vitamin deficiencies, with symptoms improving rapidly after iron supplementation. If ineffective, esophageal stricture should be considered and confirmed, followed by dilation with an esophageal bougie or high-frequency electrocoagulation incision under endoscopy. The prognosis is generally good, though some cases may persist. This condition is prone to complications such as pharyngeal and upper esophageal cancer, requiring high vigilance and regular follow-up.

The prognosis is mostly favorable, with a few cases potentially becoming chronic.

bubble_chart Complications

It is prone to complications such as pharyngeal and upper esophageal cancer.