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      Anemia ferropénica crónica: síndrome de Plummer-Vinson (Paterson-Brown-Kelly) Translated title: Chronic Iron Deficiency Anemia: Plummer- Vinson (Paterson-Brown-Kelly) Syndrome. A Case Report

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          Abstract

          Resumen El síndrome de Plummer-Vinson (Paterson-Brown-Kelly) es una entidad rara, caracterizada por disfagia, formación de membranas esofágicas y anemia por deficiencia de hierro. Presentamos el caso de una mujer de 46 años con antecedentes clínicos de anemia ferropénica de larga evolución, que posteriormente presentó disfagia y odinofagia. Se encontró una membrana subcricoidea que fue rota exitosamente con el endoscopio. Los médicos de primer contacto deben estar familiarizados de los síntomas del síndrome de Plummer- Vinson, y tenerlos en cuenta a la hora de abordar un paciente con la tríada clásica. Como el síndrome es una condición pre- cancerosa con alto potencial maligno, el diagnóstico precoz y tratamiento oportuno es de suma importancia.

          Translated abstract

          Abstract Plummer-Vinson syndrome (Paterson-Brown-Kelly) is a rare entity, characterized by dysphagia, esophageal web formation, and iron deficiency anemia. We present the case of a 46-year-old woman with a clinical history of iron deficiency anemia who subsequently presents dysphagia and odynophagia. A subcricoid web that was successfully broken with the endoscope was found. First contact doctors should be familiar with the symptoms of Plummer-Vinson syndrome, and take them into account, when addressing a patient with the classic triad. Since the syndrome is a precancerous condition with high malignant potential, early diagnosis and treatment is of utmost importance for better prognosis.

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          Most cited references9

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          Iron deficiency anemia and Plummer–Vinson syndrome: current insights

          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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            Single-center prospective study of Plummer-Vinson syndrome.

            Post-cricoid web is an uncommon cause for dysphagia and is most frequently reported in middle-aged women. Triad of web, iron deficiency anemia (IDA), and dysphagia is known as Plummer-Vinson syndrome (PVS). Literature on PVS is very limited. Here we report the first prospective study of PVS with predefined diagnostic criteria and management plan. Adults with dysphagia or those incidentally found to have esophageal web were prospectively enrolled between July 2011 and June 2013. Participants were evaluated with hemogram, barium swallow, and esophagogastroduodenoscopy. PVS was diagnosed if a person had IDA and a post-cricoid web in barium swallow and/or endoscopy. Patients were managed with dilation using through-the-scope controlled radial expansion balloon followed by oral iron and folic acid supplementation. Thirty-seven patients (age, median [range] 40 [19-65] years; 32 [86%] women) were enrolled. Thirty-one symptomatic patients had dysphagia grade 1 (n = 12, 39%), 2 (n = 13, 42%), and 3 (n = 6, 19%) for a median (range) duration of 24 (4-324) months. Barium swallow, done in 29, showed web in 25 which were either circumferential or anterior in position. Twenty-nine (29/31, 94%) patients had complete and two had partial response after the first session of endoscopic dilatation without any complication. Dysphagia recurred in three (10%) of the 30 patients who were followed for a median (range) of 10 (1-24) months. Esophageal-web related dysphagia in patients with PVS responds favorably after single session of endoscopic dilation.
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              Oral Manifestations of Plummer-Vinson Syndrome: A Classic Report with Literature Review

              Plummer-Vinson syndrome (PVS) is a triad of microcytic hypochromic anemia, atrophic glossitis, and esophageal webs or strictures. It is one of the syndromes associated with iron deficiency anemia. Symptoms resulting from anemia predominates the clinical picture, apart from the additional features such as glossitis, angular cheilitis, and dysphagia. Dysphagia is main clinical feature of PVS. PVS carries an increased risk of development of squamous cell carcinoma of esophagus and pharynx. A classic case report of PVS with clinical features, oral manifestations, malignant potential, differential diagnosis, investigation, dental implication, and treatment is discussed here with the literature review from the dentist’s point of view. The article carries a message that dental surgeons have to be familiar with the oral manifestations of anemia and be able to suspect PVS to aid in early diagnosis and prompt treatment.
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                Author and article information

                Journal
                facmed
                Revista de la Facultad de Medicina (México)
                Rev. Fac. Med. (Méx.)
                Universidad Nacional Autónoma de México, Facultad de Medicina (Ciudad de México, Ciudad de México, Mexico )
                0026-1742
                2448-4865
                April 2021
                : 64
                : 2
                : 22-25
                Affiliations
                [3] Mérida orgnameHospital Regional de Alta Especialidad de la Península de Yucatán Yucatán
                [2] Mérida orgnameHospital Regional de Alta Especialidad de la Península de Yucatán Yucatán
                [1] Culiacán Rosales Sinaloa orgnameHospital Civil de Culiacán México
                Article
                S0026-17422021000200022 S0026-1742(21)06400200022
                10.22201/fm.24484865e.2021.64.2.03
                bd9fb07c-3172-4b6a-9a71-85e669bf5a23

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 19 September 2019
                : 12 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 4
                Product

                SciELO Mexico

                Categories
                Casos clínicos

                síndrome de Paterson-Brown-Kelly,cáncer esofágico de células escamosas,membrana esofágica,anemia ferropénica crónica,Síndrome Plummer-Vinson,Paterson-Brown-Kelly syndrome,squamous cell esophageal cancer,esophageal membrane,chronic iron deficiency anemia,Plummer-Vinson syndrome

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