Plummer-Vinson Syndrome Follow-up

  • Author: Louis-Michel Wong Kee Song, MD; Chief Editor: Julian Katz, MD   more...
 
Updated: Jun 21, 2011
 

Further Inpatient Care

PVS is usually managed on an outpatient basis.

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Further Outpatient Care

Perform follow-up CBCs and iron studies in 3 months, after initiation of iron replacement, to document resolution of sideropenia and anemia.

Provide follow-up care for patients whose treatment has been initiated for the specific cause, if any, of the iron deficiency anemia.

Repeat esophageal dilations may be required in patients with recurrent dysphagia.

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Inpatient & Outpatient Medications

Ferrous preparations are administered to correct the deficiency in iron (with or without anemia).

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Complications

Although reports are inconsistent, patients with PVS seem to be at an increased risk for hypopharyngeal and esophageal cancers. A high prevalence of hypopharyngeal cancers in Swedish women in the 1930s and 1940s was attributed to PVS.[24]

The reported frequency of postcricoid carcinoma associated with PVS varies (4-16% in older studies) and remains a matter of debate.[25]

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Prognosis

Prognosis is generally good, unless PVS is complicated by hypopharyngeal or esophageal carcinoma.[26, 27] Patients with PVS usually respond well to iron therapy, diet modification, and, if necessary, esophageal dilation.

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Patient Education

Instruct patients with PVS on dietary modification and eating habits.

Educate patients with PVS about the potential association of PVS and hypopharyngeal and esophageal cancers to ensure appropriate follow-up care.

For excellent patient education resources, visit eMedicine's Arthritis Center; Blood and Lymphatic System Center; Esophagus, Stomach, and Intestine Center; and Endocrine System Center. Also, see eMedicine's patient education articles Rheumatoid Arthritis, Anemia, Celiac Sprue, and Thyroid Problems.

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Contributor Information and Disclosures
Author

Louis-Michel Wong Kee Song, MD  Associate Professor, Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic

Louis-Michel Wong Kee Song, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Specialty Editor Board

Marco G Patti, MD  Professor of Surgery, Director, Center for Esophageal Diseases, University of Chicago Pritzker School of Medicine

Marco G Patti, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Gastroenterological Association, American Medical Association, American Surgical Association, Association for Academic Surgery, Pan-Pacific Surgical Association, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, Southwestern Surgical Congress, and Western Surgical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Noel Williams, MD  Professor Emeritus, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Professor, Department of Internal Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada

Noel Williams, MD is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References

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  4. Jacobs A, Kilpatrick GS. The Paterson-Kelly syndrome. BMJ. 1964;2:79-82.

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  20. Bredenkamp JK, Castro DJ, Mickel RA. Importance of iron repletion in the management of Plummer-Vinson syndrome. Ann Otol Rhinol Laryngol. Jan 1990;99(1):51-4. [Medline].

  21. Huynh PT, de Lange EE, Shaffer HA Jr. Symptomatic webs of the upper esophagus: treatment with fluoroscopically guided balloon dilation. Radiology. Sep 1995;196(3):789-92. [Medline].

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  25. Rashid Z, Kumar A, Komar M. Plummer-Vinson syndrome and postcricoid carcinoma: late complications of unrecognized celiac disease. Am J Gastroenterol. Jul 1999;94(7):1991. [Medline].

  26. Jessner W, Vogelsang H, Püspok A, Ferenci P, Gangl A, Novacek G, et al. Plummer-Vinson syndrome associated with celiac disease and complicated by postcricoid carcinoma and carcinoma of the tongue. Am J Gastroenterol. May 2003;98(5):1208-9. [Medline].

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  28. Brown Kelly A. Spasm at the entrance of the oesophagus. J Laryngol Rhinol Otol. 1919;34:285-9.

  29. Vinson PP. Hysterical dysphagia. Minn Med. 1922;5:107-8.

 
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Postcricoid web. Courtesy of Alan Cameron, MD.
Upper esophageal web.
Upper esophageal web.
 
 
 
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