Department of Internal Medicine, St. Luke's University Hospital Health Network, Bethlehem, PA, USA.
Department of Gastroenterology, St. Luke's University Hospital Health Network, Bethlehem, PA, USA.
Am J Case Rep. 2021 Apr 24;22:e929899. doi: 10.12659/AJCR.929899.
BACKGROUND Plummer-Vinson syndrome is a rare disease that presents with iron-deficiency anemia, dysphagia, and esophageal webs. It usually occurs in middle-aged White women, and it increases the risk for esophageal cancer. The prevalence of Plummer-Vinson syndrome has decreased due to early detection of iron deficiency and repletion of iron stores. Although Plummer-Vinson syndrome has also been commonly described in children and adolescents, it is seldom reported in the elderly population. CASE REPORT An 88-year-old women with a history of mild cognitive impairment, allergic rhinitis, and gastroesophageal reflux disease presented with difficulty in swallowing solid foods. She had a decreased appetite, along with a 4.5-kg weight loss in the last 1 year. She was also found to have severe iron deficiency and mild anemia. Her dysphagia continued to progress even after starting iron supplementation for her iron deficiency. She eventually had a food bolus trapped in her cervical esophagus that required removal via esophagogastroduodenoscopy. A barium swallow revealed a narrowing in the upper esophagus. A repeat esophagogastroduodenoscopy revealed an esophageal web that was dilated, resulting in relief of symptoms. CONCLUSIONS Dysphagia is reported in up to 10% of the elderly population. It commonly causes malnutrition and is associated with increased mortality. The usual etiologies include cognitive dysfunction, neurological disorders, and/or esophageal dysmotility or narrowing. Although the incidence of Plummer-Vinson syndrome has decreased over time, the possibility of its presence should not be overlooked. To our knowledge, the current case is the third case of dysphagia related to Plummer-Vinson syndrome reported in an octogenarian in the literature so far. Iron replacement can help resolve dysphagia in Plummer-Vinson syndrome but dilation of esophageal webs may sometimes be required.
Plummer-Vinson 综合征是一种罕见疾病，表现为缺铁性贫血、吞咽困难和食管蹼。它通常发生在中年白人女性中，并且会增加患食管癌的风险。由于缺铁的早期发现和铁储存的补充，Plummer-Vinson 综合征的患病率已经降低。尽管 Plummer-Vinson 综合征在儿童和青少年中也经常被描述，但在老年人群中很少报道。
一位 88 岁女性，有轻度认知障碍、过敏性鼻炎和胃食管反流病病史，出现吞咽固体食物困难。她食欲不振，在过去 1 年中体重减轻了 4.5 公斤。她还被发现严重缺铁和轻度贫血。尽管开始补铁治疗缺铁后，她的吞咽困难仍在继续恶化。她最终在颈段食管中出现食物团块嵌顿，需要通过食管胃十二指肠镜取出。钡餐检查显示上段食管狭窄。重复食管胃十二指肠镜检查显示食管蹼扩张，症状缓解。
吞咽困难在高达 10%的老年人群中报告。它通常会导致营养不良，并与死亡率增加相关。常见病因包括认知功能障碍、神经疾病和/或食管动力障碍或狭窄。尽管随着时间的推移，Plummer-Vinson 综合征的发病率已经降低，但不应忽视其存在的可能性。据我们所知，目前的病例是迄今为止文献中报道的第三个与 Plummer-Vinson 综合征相关的 80 多岁老人吞咽困难病例。铁替代治疗可以帮助解决 Plummer-Vinson 综合征引起的吞咽困难，但有时可能需要扩张食管蹼。
