Plummer Vinson Syndrome

Plummer–Vinson syndrome is a rare disease characterized by difficulty swallowing, iron-deficiency anemia, glossitis, cheilosis and esophageal webs.

Causes of Plummer Vinson Syndrome

The cause of Plummer Vinson syndrome is unknown, however, genetic factors and nutritional deficiencies may play a role. It is more common in women, particularly in middle age, with a peak age over 50 years.

Symptoms of Plummer Vinson Syndrome

  • Dysphagia (difficulty swallowing)

  • Pain

  • Weakness

  • Odynophagia (painful swallowing)

  • Atrophic glossitis

  • Angular cheilitis

  • Koilonychia (Abnormally thin nails, also called spoon nails)

  • Splenomegaly (an enlarged spleen).

  • Upper esophageal webs (post cricoid region contrasts with Schatzki rings found at the lower end of esophagus)

Diagnosis of Plummer Vinson Syndrome

The following clinical presentations may be used in the diagnosis of this condition.

  • Dizziness

  • Pallor of the conjunctiva and face

  • Erythematous oral mucosa with burning sensation

  • Breathlessness

  • Atrophic and smooth tongue

  • Peripheral rhagades around the oral cavity

Lab tests

Complete blood cell counts, peripheral blood smears, and iron studies (e.g., serum iron, total iron-binding capacity, ferritin, and saturation percentage) to confirm iron deficiency, either with or without hypochromic microcytic anemia


Barium esophagography and video fluoroscopy will help to detect esophageal webs. Esophago-gastroduodenoscopy will enable visual confirmation of esophageal webs. The webs occur due to sub-epithelial fibrosis.

Treatment of Plummer Vinson Syndrome

  • Treatment is primarily aimed at correcting the iron-deficiency anemia.

  • Patients with Plummer–Vinson syndrome should receive iron supplementation in their diet.

  • This may improve dysphagia and pain.

  • If not, the web can be dilated with esophageal bougies during upper endoscopy to allow normal swallowing and passage of food.

  • There is risk of perforation of the esophagus with the use of dilators for treatment.

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