Korean J Gastroenterol.  2014 Apr;63(4):244-247. 10.4166/kjg.2014.63.4.244.

A Case of Plummer-Vinson Syndrome Associated with Crohn's Disease

• Park JM
• Kim KO
• Park CS
• Jang BI

• KMID: 1791882
• DOI: http://doi.org/10.4166/kjg.2014.63.4.244

Abstract

Plummer-Vinson syndrome manifests as cervical dysphagia, iron deficiency anemia, an upper esophageal web, and atrophic glossitis. The cause of the esophageal web is thought to be iron deficiency anemia; however, the cause of Plummer-Vinson syndrome has not been established. Crohn's disease is usually accompanied by malnutrition and iron deficiency anemia; however, no case of concomitant Crohn's disease and Plummer-Vinson syndrome with aggravated malnutrition and anemia has been previously reported. Here, we report on a rare case of Plummer-Vinson syndrome in a Crohn's disease patient, which caused malnutrition and constipation.

Keyword

Plummer-Vinson syndrome; Malnutrition; Deglutition disorders; Crohn disease

MeSH Terms

Adult
Cobblestone Lissencephaly/diagnosis
Colon, Sigmoid/surgery
Crohn Disease/complications/*diagnosis
Esophageal Sphincter, Upper/radiography
Humans
Male
Plummer-Vinson Syndrome/*diagnosis/etiology
Sigmoidoscopy
Sphincterotomy, Endoscopic
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Esphagogastroduodenoscopic finding. At the upper esophagus (near the upper esophageal sphincter) a white colored circumferential web was noted. The scope could not be passed through the lesion.

• 

  Fig. 2. Esophagography. A shelf-like filling suspicious for esophageal web defect was observed at the anterior wall with dilatation of the proximal part (A: frontal view, B: lateral view).

• 

  Fig. 3. Sigmoidoscopic finding. Cobble stone appearance with ulceration and luminal narrowing with stricture was noted at 20 cm from the anal verge.

• 

  Fig. 4. Abdominal computed tomography. Ascites and terminal ileal wall thickening were observed. The arrow indicates one of the multiple strictures with prestenotic dilatation and bowel wall thickening at the left side colon.

Reference

References

1. Novacek G. Plummer-Vinson syndrome. Orphanet J Rare Dis. 2006; 1:36.

2. Nosher JL, Campbel WL, Seaman WB. The clinical significance of cervical esophageal and hypopharyngeal webs. Radiology. 1975; 117:45–47.

3. Wynder EL, Hultberg S, Jacobsson F, Bross IJ. Environmental factors in cancer of the upper alimentary tract; a Swedish study with special reference to Plummer-Vinson (Paterson-Kelly) syndrome. Cancer. 1957; 10:470–487.

4. Hartman C, Eliakim R, Shamir R. Nutritional status and nutritional therapy in inflammatory bowel diseases. World J Gastroenterol. 2009; 15:2570–2578.

5. Sitrin MD. Nutrition support in inflammatory bowel disease. Nutr Clin Pract. 1992; 7:53–60.

6. Silk DB, Payne-James J. Inflammatory bowel disease: nutritional implications and treatment. Proc Nutr Soc. 1989; 48:355–361.

7. Nagel E, Canzler H, Pichlmayr R. What is the role of nutrition in Crohn disease? A contribution to the importance of dietary therapy in regional enteritis. Langenbecks Arch Chir. 1991; 376:238–246.

8. Afonso JJ, Rombeau JL. Nutritional care for patients with Crohn's disease. Hepatogastroenterology. 1990; 37:32–41.