Field Zachary, Russin Michelle, Kropf Jacqueline, Olivier Maxim, Ge Li, Galili Yehuda, Carlan Steve J
Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, USA.
University of Central Florida College of Medicine, Orlando, FL, USA.
Am J Case Rep. 2019 Aug 27;20:1264-1267. doi: 10.12659/AJCR.916823.
BACKGROUND Plummer-Vinson syndrome (PVS) is a rare disorder composed of the triad of dysphagia, iron-deficiency anemia (IDA), and esophageal webs. It is most prevalent in middle-aged white women, and the dysphagia often improves when the anemia is treated. It is well established that chronic hypertension can lead to congestive heart failure (CHF). While IDA is frequently found concomitantly with CHF, there have been no reported cases of new-onset CHF with anemia presenting as PVS. CASE REPORT We present the case of a 48-year-old African American woman with symptomatic anemia and new-onset congestive heart failure secondary to hypertension, who presented with the classic symptoms of PVS. CONCLUSIONS CHF with accompanying IDA may be an independent risk factor for the development of PVS. At the very least, there is an association between CHF-induced IDA and PVS. Patients presenting with CHF with symptoms of dysphagia should be considered at risk for the syndrome, and endoscopy may be warranted. Treatment for PVS includes iron replacement, and in some cases requires mechanical dilation.
背景
普卢默-文森综合征(PVS)是一种罕见疾病,由吞咽困难、缺铁性贫血(IDA)和食管蹼三联征组成。它在中年白人女性中最为常见,贫血得到治疗后吞咽困难通常会改善。众所周知,慢性高血压可导致充血性心力衰竭(CHF)。虽然IDA常与CHF同时出现,但尚无新发CHF伴贫血表现为PVS的病例报道。
病例报告
我们报告一例48岁非裔美国女性病例,该患者有症状性贫血,继发于高血压的新发充血性心力衰竭,并伴有PVS的典型症状。
结论
伴有IDA的CHF可能是PVS发生的独立危险因素。至少,CHF引起的IDA与PVS之间存在关联。出现CHF并伴有吞咽困难症状的患者应被视为该综合征的高危人群,可能需要进行内镜检查。PVS的治疗包括补充铁剂,在某些情况下需要进行机械扩张。