Aubry P, Oddes B, Chazouillères O, Lebourgeois M, Delanoue G, Seurat P L
Ann Gastroenterol Hepatol (Paris). 1985 Feb-Mar;21(2):113-6.
The Plummer-Vinson syndrome or "sideropenic dysphagia" is exceptional among Blacks. One case was recently reported in a female patient from Guadeloupe. This study pertains to three cases observed in Senegalese Black women aged 28, 27, and 41 years. These three women were admitted for a dysphagia, in fact in evidence 10, 4, and 7 years respectively before the diagnosis was made. A clinical anemia was noted twice in addition to mucocutaneous disorders (cases 1 and 2). The laboratory tests showed in all three cases a hypochromic microcytic sideropenic anemia (serum iron levels at 32, 14, and 31 mcg 100 ml respectively). Barium swallow films showed esophageal rings in front of C5-C6 (case 1) of T2-T3 (case 2) and a web of fine mucosal folds in front of C5-C6 (case 3). These films were confirmed cineradiographically by esophagoscopy. The treatment consisted of blood transfusions (cases 1 and 2) and administration of iron by injections and or per os. The endoscopic exams were repeated two or three times. Medical treatment rapidly changed the course of disease for the better. No cause for bleeding was found. A chemical achlorhydria (case 1), a provoked hypoachlorhydria (cases 2 and 3) can be retained as associated factors. In light of the frequency of esophageal membranes in the general population and the incidence of sideropenic anemias among African women, the Plummer-Vinson syndrome should be more often detected in Black Africa.
普卢默 - 文森综合征或“缺铁性吞咽困难”在黑人中较为罕见。最近有一例来自瓜德罗普岛的女性患者的报道。本研究涉及在三名年龄分别为28岁、27岁和41岁的塞内加尔黑人女性中观察到的三例病例。这三名女性因吞咽困难入院,实际上在确诊前分别有10年、4年和7年的吞咽困难症状。除了皮肤黏膜疾病外(病例1和病例2),还两次发现临床贫血。实验室检查显示,所有三例均为低色素小细胞缺铁性贫血(血清铁水平分别为32、14和31微克/100毫升)。吞钡造影显示在C5 - C6水平前方有食管环(病例1),T2 - T3水平前方有食管环(病例2),以及在C5 - C6水平前方有细黏膜皱襞网(病例3)。这些造影结果经食管镜检查的动态放射摄影得到证实。治疗包括输血(病例1和病例2)以及通过注射和/或口服给予铁剂。内镜检查重复了两到三次。药物治疗迅速使病情好转。未发现出血原因。可以认为存在化学性胃酸缺乏(病例1)、诱发性胃酸缺乏(病例2和病例3)等相关因素。鉴于普通人群中食管黏膜的出现频率以及非洲女性中铁缺乏性贫血的发病率,普卢默 - 文森综合征在黑非洲地区应该更常被发现。