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Plummer-Vinson; Patterson-Kelly syndrome; sideropenic dysphagia
Epidemiology: 90% of cases occur in women
Pathology:
1) a cervical esophageal web
2) mucosal lesions of the mouth & pharynx
3) iron-deficiency anemia
4) association (15%) with squamous cell carcinoma of the oropharynx & upper esophagus
Clinical manifestations:
1) intermittent dysphagia*
2) sore tongue
3) dry mouth
4) cheilitis
5) erythematous buccal mucosa & tongue
6) spoon-shaped nails
7) splenomegaly
* dysphagia (often with aspiration of food) is the most common clinical manifestation
Laboratory:
- complete blood count -> anemia, microcytosis
- serum iron, TIBC, serum ferritin
- labs consistent with iron-deficiency anemia
Radiology:
- anterior displacement of barium by web-like stricture in upper esophagus
Management:
- dysphagia apparently resolves with correction of the anemia
General
anemia
esophageal disease
syndrome
References
- Rubin & Farber, Pathology, 2nd ed. JB Lippincott
Philadelphia, 1994, pg 621
- DeGowin & DeGowin's Diagnostic Examination, 6th edition,
RL DeGowin (ed), McGraw Hill, NY 1994, pg 924
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 281