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      Síndrome de Plummer-Vinson: a propósito de un caso Translated title: Síndrome de Plummer-Vinson: relato de caso Translated title: Plummer-Vinson syndrome: a case study

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          Abstract

          Resumen: Presentamos el caso de una paciente de sexo femenino de 40 años que consultó por astenia, adinamia, mareos y disnea progresiva de diez meses de evolución agregando en los últimos cuatro meses disfagia intermitente para sólidos. La radiografía esofágica con bario evidenció la presencia de una estenosis subcricoidea con buen pasaje distal y la videogastroscopía demostró inmediatamente por debajo del cricofaríngeo una membrana fibrosa estenosante. Se realizó tratamiento con hierro vía oral y reiteradas sesiones de dilatación con balón que lograron la resolución de los síntomas. El síndrome de Plummer-Vinson es una entidad poco frecuente caracterizada por la tríada anemia ferropénica, disfagia y membrana esofágica alta.

          Translated abstract

          Resumo: Apresentamos o caso de uma paciente de sexo feminino de 40 anos que consultou por astenia, adinamia, tontura e dispneia progressiva com 10 meses de evolução e disfagia intermitente para sólidos nos últimos 4 meses. A radiografia esofágica com bário mostrou a presença de estenose abaixo da cartilagem cricoide com boa passagem distal e a endoscopia digestiva alta evidenciou membrana fibrosa estenosante logo abaixo do cricofaríngeo. Realizou-se tratamento com ferro por via oral e várias sessões de dilatação com balão com eliminação dos sintomas. A síndrome de Plummer-Vinson é uma doença rara caracterizada pela tríade ferropenia, disfagia e membrana esofágica alta.

          Translated abstract

          Abstract: The study presents the case of a 40 year old female patient who consulted for asthenia, adynamia, dizziness and progressive dyspnea with 10 months of evolution, evidencing intermittent solid dysphagia in the last 4 months. Barium X-rays of the esophagus evidenced subcricoid stenosis with good distal passage and the gastroscopy immediately showed a stenosing fibrous membrane under the cricopharyngeal. Iron oral treatment was initiated and several sessions with a balloon catheter which solved the symptoms. Plummer-inson syndrome is a rare entity characterized by iron deficiency anemia, dysphagia and a high esophageal membrane.

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          Most cited references18

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          Riboflavin and health: A review of recent human research.

          There has lately been a renewed interest in Riboflavin owing to insight into its recognition as an essential component of cellular biochemistry. The knowledge of the mechanisms and regulation of intestinal absorption of riboflavin and its health implications has significantly been expanded in recent years. The purpose of this review is to provide an overview of the importance of riboflavin, its absorption and metabolism in health and diseased conditions, its deficiency and its association with various health diseases, and metabolic disorders. Efforts have been made to review the available information in literature on the relationship between riboflavin and various clinical abnormalities. The role of riboflavin has also been dealt in the prevention of a wide array of health diseases like migraine, anemia, cancer, hyperglycemia, hypertension, diabetes mellitus, and oxidative stress directly or indirectly. The riboflavin deficiency has profound effect on iron absorption, metabolism of tryptophan, mitochondrial dysfunction, gastrointestinal tract, brain dysfunction, and metabolism of other vitamins as well as is associated with skin disorders. Toxicological and photosensitizing properties of riboflavin make it suitable for biological use, such as virus inactivation, excellent photosensitizer, and promising adjuvant in chemo radiotherapy in cancer treatment. A number of recent studies have indicated and highlighted the cellular processes and biological effects associated with riboflavin supplementation in metabolic diseases. Overall, a deeper understanding of these emerging roles of riboflavin intake is essential to design better therapies for future.
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            Plummer-Vinson syndrome

            Plummer-Vinson or Paterson-Kelly syndrome presents as a classical triad of dysphagia, iron-deficiency anemia and esophageal webs. Exact data about epidemiology of the syndrome are not available; the syndrome is extremely rare. Most of the patients are white middle-aged women, in the fourth to seventh decade of life but the syndrome has also been described in children and adolescents. The dysphagia is usually painless and intermittent or progressive over years, limited to solids and sometimes associated with weight loss. Symptoms resulting from anemia (weakness, pallor, fatigue, tachycardia) may dominate the clinical picture. Additional features are glossitis, angular cheilitis and koilonychia. Enlargement of the spleen and thyroid may also be observed. One of the most important clinical aspects of Plummer-Vinson syndrome is the association with upper alimentary tract cancers. Etiopathogenesis of Plummer-Vinson syndrome is unknown. The most important possible etiological factor is iron deficiency. Other possible factors include malnutrition, genetic predisposition or autoimmune processes. Plummer-Vinson syndrome can be treated effectively with iron supplementation and mechanical dilation. In case of significant obstruction of the esophageal lumen by esophageal web and persistent dysphagia despite iron supplementation, rupture and dilation of the web are necessary. Since Plummer-Vinson syndrome is associated with an increased risk of squamous cell carcinoma of the pharynx and the esophagus, the patients should be followed closely.
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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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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                rmu
                Revista Médica del Uruguay
                Rev. Méd. Urug.
                Sindicato Médico del Uruguay (Montevideo, , Uruguay )
                0303-3295
                1688-0390
                March 2019
                : 35
                : 1
                : 186-189
                Affiliations
                [1] Montevideo orgnameMédica Uruguaya Corporación de Asistencia Médica (MUCAM) orgdiv1Centro de Referencia Regional Olympus (Ce.V.En) orgdiv2Servicio de Endoscopía Digestiva Uruguay fedesi05@ 123456yahoo.com.ar
                [2] Montevideo orgnameMédica Uruguaya Corporación de Asistencia Médica (MUCAM) orgdiv1Centro de Referencia Regional Olympus (Ce.V.En) orgdiv2Servicio de Endoscopía Digestiva Uruguay
                Article
                S1688-03902019000100186
                10.29193/rmu.35.11
                dff1337b-dd04-4501-9bf5-ce0e92229169

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

                History
                : 18 August 2018
                : 15 November 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 4
                Product

                SciELO Uruguay

                Categories
                Caso Clínico

                Case reports,Síndrome de Plummer-Vinson,Anemia ferropénica,Informes de casos,Anemia, iron-deficiency,Plummer-Vinson Syndrome,Relatos de casos,Anemia ferropriva

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