Plummer-Vinson Syndrome: A Retrospective Multicenter Study

Abstract

Background: Plummer-Vinson syndrome (PVS) is a rare disorder characterized by post-cricoid dysphagia, iron deficiency anemia (IDA), and upper esophageal web formation. Despite its clinical significance and potential progression to esophageal squamous cell carcinoma (SCC), data on PVS remain limited. This study aims to analyze the demographic, clinical, imaging characteristics, and treatment outcomes of PVS across multiple centers.

Methods: A retrospective, multicenter study was conducted across seven high-volume tertiary GI endoscopy centers in Egypt, India, and Iraq between 2021 and 2024. Medical records of consecutive patients diagnosed with PVS, based on the presence of post-cricoid dysphagia, IDA, and upper esophageal web, were reviewed. Clinical data, laboratory investigations, imaging findings, and treatment modalities were analyzed.

Results: A total of 56 patients were included, with a mean age of 41 ± 17 years; 80.5% were female. Post-cricoid dysphagia and IDA were present in all cases, with a mean hemoglobin level of 8.2 ± 1.5 g/dL and serum ferritin of 10.34 ± 5.2 ng/mL. Coeliac disease was the most common associated condition (10.7%). Endoscopic dilation was the primary treatment, with Savary-Gilliard bougie dilators used in 89% of cases. A single dilation session was sufficient in 76.8% of patients. During follow-up, 7.1% developed esophageal SCC/dysplasia. No significant post-dilation complications were observed.

Conclusion: PVS predominantly affects middle-aged women and is strongly associated with IDA. Endoscopic dilation is an effective treatment, with most patients responding to a single session. Given the potential risk of malignant transformation, close monitoring is essential. Further research is needed to elucidate pathogenesis and optimize management strategies for PVS.

Keywords: Dysphagia; Endoscopic dilation; Esophageal cancer; Esophageal web; Iron deficiency anemia; Plummer-Vinson syndrome.