P0530 - A Case of Plummer Vinson Syndrome: An Overlooked Pathology

Juliana Pava-De Los Rios, MD, Jessica Hidalgo, MD, Arbaaz Rao, MD, Carlos Valladares, MD
Rutgers Health/Community Medical Center, Toms River, NJ

Introduction: Plummer Vinson Syndrome (PVS) is a rare etiology that consists of iron deficiency anemia, dysphagia and esophageal strictures. (1). It is most common in middle-aged women, mainly Caucasian.(2)(4). The dysphagia is more associated with solids, and it worsens over time and it is painless (2).

Etiology and pathophysiology of PVS is still unknown (4), the most accepted mechanism is that the iron deficiency plays a big role on the development of the webs, because, the iron deficiency produces alterations in the DNA of the esophageal mucosa predisposing to the formation of webs (4).There have been reported cases in which the dysphagia improves after iron supplementation (1). The esophageal web is thin and composed of squamous epithelia. (1) In general, the histology of the web shows features of chronic inflammation (1).

Case Description/Methods: 54-year-old female presents to her PCP due to progressive fatigue, present for about 4 months aside from the fatigue patient also presented with dysphagia mostly to solids, and HgB found to be 7 gr. Patient was referred to hematologist. She has no significant bleeding history, no GI surgeries, no hematologic disorders, no family history of anemia. Patient was started on iron infusions and her HgB improved. Patient was referred to GI to get EGD and colonoscopy for evaluation of the dysphagia, EGD was done and findings of multiple benign-appearing, intrinsic severe stenoses found on the upper third of the esophagus. Narrowest stenosis measured 2 mm, dilation was done. Patient then received multiple EGDs and dilations to help the the symptoms. Biopsies were taken from the stenoses and showed mild chronic inflammation.
With the presence of dysphagia, esophageal stenoses and iron deficiency anemia diagnosis of PVS was made. Patient to get new EGD in 1 month to do dilation if pertinent.

Discussion: First case of PVS was described over a 50 years ago in the literature, however the etiology of this pathology is largely unknown, (4) the literature available is due to case reports. Due to this the etiology is largely underdiagnosed, in this case the patient presented with iron deficiency anemia and after 4 months of follow ups the diagnosis of PVS was made. Patient underwent dilations and benign pathology was reported. She improved significantly after dilation. Patient is doing very good at the moment; iron deficiency is being treated which decreased the symptoms as well.



Disclosures:


Juliana Pava-De Los Rios, MD, Jessica Hidalgo, MD, Arbaaz Rao, MD, Carlos Valladares, MD. P0530 - A Case of Plummer Vinson Syndrome: An Overlooked Pathology, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.