Mayo Clinic Proceedings Home

Plummer-Vinson Syndrome

  • Satvinder Singh Bakshi
    Correspondence
    Correspondence: Address to Satvinder Singh Bakshi, MS, DNB, Department of ENT and Head & Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Piliaiyarkuppam, Pondicherrry 607402, India.
    Affiliations
    Department of ENT and Head & Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Pondicherry, India
    Search for articles by this author
      A 32-year-old woman presented with a history of fatigability for 9 months and progressive difficulty in swallowing solids for 2 months. On examination she was pale and had glossitis, cheilitis (Figure), and koilonychia. Blood analysis revealed microcytic hypochromic anemia with anisocytosis, a hemoglobin level of 6 g/dL (normal, 12-14 g/dL), mean corpuscular volume of 65 fL (normal, 80-95 fL), mean corpuscular hemoglobin of 19 pg/dL (normal, 27-32 pg/dL), serum iron level of 22 μg/dL (normal, 50-140 μg/dL), serum ferritin level of 14 ng/mL (normal, 25-250 ng/mL), and total iron-binding capacity of 495 μg/dL (normal, 245-450 μg/dL). A provisional diagnosis of Paterson-Brown-Kelly syndrome was made. Barium swallow revealed a 1.3-cm web in the postcricoid region (Supplemental Figure, available online at http://www.mayoclinicproceedings.org), which was subsequently dilated using an esophagoscope. Anemia was corrected with oral hematinics, and the hemoglobin level eventually improved to 11 g/dL. The dysphagia resolved, and she has been asymptomatic for 5 months on last follow-up. The Paterson-Brown-Kelly syndrome, also called the Plummer-Vinson syndrome or sideropenic dysphagia, consists of a triad of dysphagia, iron deficiency anemia, and esophageal webs. It was first described by Henry Stanley Plummer in the beginning of the 20th century and later on by Porter Paisley Vinson. Patterson and Kelly were the first to describe the clinical signs and symptoms, namely, dysphagia, glossitis, cheilitis, iron deficiency anemia, and koilonychia. The exact etiology is still unclear. It is thought to be a premalignant condition, and regular follow-up is warranted. The symptoms usually resolve by correction of anemia; however, dilatation of the web may be necessary for relieving the dysphagia.
      Figure thumbnail gr1
      FigureFemale patient with pallor, glossitis, and cheilitis.

      Supplemental Online Material

      Figure thumbnail figs1
      Supplemental FigureBarium swallow showing the postcricoid web.

      Supplemental Online Material

      Supplemental material can be found online at: http://www.mayoclinicproceedings.org. Supplemental material attached to journal articles has not been edited, and the authors take responsibility for the accuracy of all data.