The Plummer-Vinson syndrome: a retrospective study of 50 cases

Aim: The aim of the study was to describe the characteristic features (epidemiological, clinical, paraclinical, therapeutic and evolutive) of the Plummer-Vinson syndrome. Methods: A retrospective and descriptive study was conducted from May 1997 to May 2010 including every patient hospitalized in the medical departments of the "hopital Principal de Dakar" for dysphagia, iron deficiency anemia and upper esophageal web or stricture. Results: Fifty patients were included. The mean age was 35.6 years and the sex-ratio 0.14. Laboratory tests showed an iron deficiency anemia in all patients with mean values of haemoglobin of 7.36 g/dl, serum iron 0.26 mg/l and of ferritin 6.65 mu g/l. Esophagoscopy showed an upper esophageal web or stricture without web. The cause of iron deficiency was found in 16 patients (32%) who presented uterin myomatose with menorrhage (n = 5), increased menstrual blood loss (n = 10) and grade III esophageal varices (n = 1). The treatment included iron supplementation in all patients. An accidental web disruption occurred in 6 cases (12%) during the first endoscopic session. Savary Gilliard dilatation was performed in 36 patients (72%). In short term follow-up (0-6 months), the outcome was favourable with an improvement of dysphagia and complete resolution of biological abnormalities. Conclusion: The Plummer-Vinson syndrome affects mainly reproductive women. The incidence is still rare in a context where iron deficiency is very common. The treatment includes iron supplementation and mechanical dilatation. The outcome is always favourable in short term follow-up.