Women with vitamin B12 deficiency presents with dysphagia and anemia. What is the syndrome that describes this presentation?
Correct Answer: Plummer Vinson syndrome
Description: Classical features of Plummer-Vinson (Patterson Brown-kelly) Syndrome includes dysphagia, iron deficiency anemia, upper esophageal inflammation with web formation, angular stomatitis and gastritis. It usually affects females in their fouh or fifth decade. Esophageal webs are formed at the junction between squamous mucosa of esophagus and islands of gastric type mucosa in the upper esophagus. Barium swallow shows a web in the post-cricoid region and the same can be seen on oesophagoscopy. It is due to subepithelial fibrosis in this region. About 10% of the cases with this syndrome will develop post-cricoid carcinoma. Treatment: Primary treatment is to correct anemia by oral/parenteral iron. Associated B12 and B6 deficiency should also be corrected. Dilatation of the webbed area by esophageal bougies help to relieve dysphagia.
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