-Plummer-Vinson Syndrome.

Plummer-Vinson Syndrome

- Synonyms:-

Chronic Pharyngo-oesophagitis or Patterson-Brown-Kelly's disease.

-Definition:-

Chronic inflammation of the mucous membrane of the hypopharynx and upper oesophagus.

-Aetiology:-

Unknown, may be iron deficiency anaemia, vitamin deficiency or autoimmune.

- Incidence:-

Commonly in females above 40 years.

-Pathology:-

Atrophic mucosa and submucosal fibrosis leading to formation of webs.

-Clinical picture:-

Symptoms: gradual progressive dysphagia.

Signs:-

• Angular stomatitis with fissured angles of the mouth
• glossitis: (smooth glazed dry tongue)
• glazed atrophic mucosa of the hypopharynx and upper oesophagus with mucosal webs
• splenomegaly
• spooning of the nails (Koilonychia).

-Investigations:-

• Blood picture shows hypochromic microcytic anaemia.
• Gastric secretions: achlorohydria due to atrophic gastritis may be caused by vit. B12 deficiency.
• Hypopharyngoscopy: web formation and stenosis.

- Complications:-

• Submucosal fibrosis leading to web formation and stenosis.
• Pre-cancerous leads to Post-cricoid carcinoma.

-Treatment:-

• Iron and vitamin B complex by injection.
• Repeated endoscopic dilatation.
• Regular follow up to detect early post-cricoid carcinoma.

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