Plummer-Vinson syndrome natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
If left untreated, patients of Plummer-Vinson syndrome may progress to develop fatigue, dyspnea on exertion, esophageal strictures, and malignant lesions of the mouth and oral cavity. Common complications of Plummer-Vinson syndrome include hypopharyngeal cancer, esophageal cancer and malignant lesions of oral mucosa. Depending on the extent of Plummer-Vinson syndrome at the time of diagnosis, the prognosis may vary. Prognosis is generally good for patients who receive treatment. Iron replacement therapy and dilatation of esophageal web leads to rapid reversal of symptoms.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of Plummer-Vinson syndrome usually develop in the fourth decade of life, and start with symptoms such as fatigue, swollen tongue and pain while swallowing.
- If left untreated, patients of Plummer-Vinson syndrome may progress to develop dysphagia, esophageal strictures, pharyngeal and esophageal cancer.
- Initially patients of Plummer-Vinson syndrome presents with dysphagia for solid food.
- As the disease progresses, esophageal webs and strictures become more apparent and progress to present with dysphagia for solid, choking spells and aspiration.
- Untreated Plummer-Vinson syndrome has the potential to transform into hypopharyngeal and esophageal carcinoma (squamous cell carcinoma).
Complications
Prognosis
- Depending on the extent of Plummer-Vinson syndrome at the time of diagnosis, the prognosis may vary.[3][4][5]
- Prognosis is generally good for patients of Plummer-Vinson syndrome who receive treatment unless the disease has been complicated by pharyngeal or esophageal carcinoma.
- Anemia and esophageal webs seen in Plummer-Vinson syndrome can be rapidly reversed with iron replacement therapy and esophageal dilatation respectively.
- Studies have shown that patients of Plummer-Vinson syndrome are at a risk (10-15%) of developing malignant lesions of the oral mucosa, hypopharynx and esophagus. Therefore, patients require regular surveillance (upper gastrointestinal endoscopy is recommended every year) and close follow up.[6]
References
- ↑ Larsson LG, Sandström A, Westling P (1975). "Relationship of Plummer-Vinson disease to cancer of the upper alimentary tract in Sweden". Cancer Res. 35 (11 Pt. 2): 3308–16. PMID 1192404.
- ↑ Rashid Z, Kumar A, Komar M (1999). "Plummer-Vinson syndrome and postcricoid carcinoma: late complications of unrecognized celiac disease". Am. J. Gastroenterol. 94 (7): 1991. doi:10.1111/j.1572-0241.1999.01991.x. PMID 10406289.
- ↑ Tahara T, Shibata T, Okubo M, Yoshioka D, Ishizuka T, Sumi K, Kawamura T, Nagasaka M, Nakagawa Y, Nakamura M, Arisawa T, Ohmiya N, Hirata I (2014). "A case of plummer-vinson syndrome showing rapid improvement of Dysphagia and esophageal web after two weeks of iron therapy". Case Rep Gastroenterol. 8 (2): 211–5. doi:10.1159/000364820. PMC 4086037. PMID 25028578.
- ↑ Samad A, Mohan N, Balaji RV, Augustine D, Patil SG (2015). "Oral manifestations of plummer-vinson syndrome: a classic report with literature review". J Int Oral Health. 7 (3): 68–71. PMC 4385731. PMID 25878483.
- ↑ Jessner W, Vogelsang H, Püspök A, Ferenci P, Gangl A, Novacek G, Bodisch A, Wenzl E (2003). "Plummer-Vinson syndrome associated with celiac disease and complicated by postcricoid carcinoma and carcinoma of the tongue". Am. J. Gastroenterol. 98 (5): 1208–9. doi:10.1111/j.1572-0241.2003.07438.x. PMID 12809857.
- ↑ Hoffman RM, Jaffe PE (1995). "Plummer-Vinson syndrome. A case report and literature review". Arch. Intern. Med. 155 (18): 2008–11. PMID 7575056.