Patel Keshav, Kassir Mahmoud, Patel Madhav, Eichorn Wesley
Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA.
Department of Family and Community Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA.
Case Rep Gastroenterol. 2021 Jun 22;15(2):557-561. doi: 10.1159/000516937. eCollection 2021 May-Aug.
Plummer-Vinson syndrome (PVS) presents with the classic triad of iron-deficiency anemia, dysphagia, and esophageal webs. The mainstay treatment of PVS is iron supplementation and the dysphagia usually responds to iron supplementation before the hematologic abnormalities are corrected. This syndrome classically affects middle-aged Caucasian women and very few cases have been reported in African Americans. We present a rare case of PVS in an African-American woman. A 63-year-old woman presented with shortness of breath, dysphagia, and lightheadedness for several weeks. Chest X-ray was negative for any acute abnormalities. Initial hemoglobin was 7.0 g/dL, which improved to 7.5 g/dL after 1 unit of packed red blood cells. She had a mean corpuscular volume of 62 fL, a ferritin level of 6 ng/mL, and an iron level of 12 μg/dL. Fecal occult blood test was negative and barium swallow revealed a proximal esophageal web. Her dysphagia did not significantly improve despite intravenous iron supplementation and esophageal web dilation. Video-fluoroscopic swallow study revealed esophageal and pharyngeal phase dysphagia with food entrapment. She was discharged with plans to follow up with a primary care physician and repeat esophagogastroduodenoscopy in 1 year. This case report highlights a rare case of PVS in an African-American woman and emphasizes the importance of maintaining a comprehensive and broad differential diagnosis.
普卢默-文森综合征(PVS)表现为缺铁性贫血、吞咽困难和食管蹼这一经典三联征。PVS的主要治疗方法是补充铁剂,在血液学异常得到纠正之前,吞咽困难通常对补充铁剂有反应。该综合征典型地影响中年白人女性,非裔美国人中报道的病例极少。我们报告一例非裔美国女性患PVS的罕见病例。一名63岁女性因气短、吞咽困难和头晕数周前来就诊。胸部X线检查未发现任何急性异常。初始血红蛋白为7.0 g/dL,输注1单位浓缩红细胞后升至7.5 g/dL。她的平均红细胞体积为62 fL,铁蛋白水平为6 ng/mL,铁水平为12 μg/dL。粪便潜血试验阴性,吞钡检查显示食管近端有蹼。尽管静脉补充铁剂并进行了食管蹼扩张,她的吞咽困难仍未明显改善。视频透视吞咽研究显示食管和咽期吞咽困难伴食物嵌塞。她出院时计划随访初级保健医生,并在1年后复查食管胃十二指肠镜检查。本病例报告突出了一名非裔美国女性患PVS的罕见病例,并强调了保持全面广泛鉴别诊断的重要性。