P2238 - Rare Plummer-Vinson Syndrome in a Woman of Southwest Asian Descent

John Pueringer, DO, James S. Love, MD, Anna Lipowska, MD
University of Illinois College of Medicine, Chicago, IL

Introduction: Plummer-Vinson Syndrome (PVS) is a rare triad of dysphagia, iron deficiency anemia (IDA), and esophageal web formation. PVS classically affects middle-aged Caucasian women. In the literature, no cases have been reported in women of Southwest Asian descent. Despite its rarity, PVS remains an important clinical entity, as its early recognition and management can substantially improve the quality of life for affected individuals. This case helps highlight the varied populations PVS can affect and guide the diagnosis and timely management of this rare disease.

Case Description/Methods: A 36-year-old woman from Pakistan was referred to a tertiary care center with dysphagia for several years duration, cheilitis, and glossitis. She reported solid food dysphagia and pills getting stuck in the throat. She denied weight loss, hematochezia, melena, or menorrhagia. Home medications included omeprazole daily for acid reflux. Physical exam was notable for cheilitis and glossitis with a beefy red tongue. Barium esophagram demonstrated a proximal esophageal web, which was confirmed on esophagogastroduodenoscopy (EGD) (Figure 1). EGD biopsies were negative for dysplasia, celiac disease, and eosinophilic esophagitis. Labs showed a hemoglobin of 5.0 g/dL (11.7-16 g/dL), mean corpuscular volume 51.6 fL (80-99 fL), ferritin level 1 ng/mL (0-116 ng/mL), and iron level < 10 μg/dL (35-170 μg/dL). Upper endoscopy and colonoscopy did not reveal source of anemia and the patient required serial endoscopic dilations to treat the stenosis. Given the triad of dysphagia, iron-deficiency anemia, and esophageal webbing, she was diagnosed with PVS. The patient was treated with blood transfusion, intravenous iron transfusion and oral iron supplements. Four months later, her hemoglobin improved to 11.4 g/dL and dysphagia resolved.

Discussion: PVS, classically seen with IDA, glossitis, and dysphagia, commonly affects middle-aged Caucasian women, but can occur in other demographics. No cases in Southwest Asian women have been reported in current literature. Dysphagia often resolves with iron supplementation, but our patient required both iron supplementation and multiple endoscopic dilations for adequate treatment. Identifying the cause of iron deficiency is crucial; our patient underwent extensive evaluation, revealing no gastrointestinal or other pathology, and was confirmed to have a nutritional deficiency stemming from dietary factors. Since correction, both anemia and dysphagia have resolved.



Disclosures:


John Pueringer, DO, James S. Love, MD, Anna Lipowska, MD. P2238 - Rare Plummer-Vinson Syndrome in a Woman of Southwest Asian Descent, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.