Plummer-Vinson Syndrome in Senegal: A Report of 219 Cases at the Aristide Le Dantec Hospital in Dakar

Abstract

Introduction: Plummer-Vinson syndrome (PVS), also known as Kelly-Paterson syndrome, is a rare condition classically defined by the combination of dysphagia, iron-deficiency anemia, and a mucosal web of the cervical esophagus. The objective of our study was to describe the epidemiological, clinical, paraclinical, therapeutic, and outcome characteristics of PVS in our setting, and to identify factors associated with web resolution, recurrence, and the presence of gastrointestinal cancer. Patients and Methods : We conducted a retrospective, descriptive, and analytical study from 1 January 2005 to 31 December 2022 at the digestive endoscopy center of the Hepato-Gastroenterology Department of Aristide Le Dantec Hospital in Dakar. We included all patients in whom esophagogastroduodenoscopy revealed a mucosal web of the cervical esophagus compatible with PVS. Results : The prevalence of SPV was 1.04%. The mean age was 36 years [13 - 96 years], and the sex ratio was 0.10. Dysphagia was present in all patients. Hypochromic microcytic anemia was found in 54% of patients. On endoscopy, all patients had a stenosing membranous ring in the cervical esophagus. At the time of diagnosis, 8 patients had esophageal cancer and two had gastric cancer. Endoscopic dilation was performed in 89% of patients. At 9 months, 16 patients had persistent dysphagia, 28 had recurrence of the ring, and 7 had a refractory stricture; one case of high-grade dysplasia was observed after 10 years of follow-up. In univariate analysis, a high location of dysphagia and a normal serum iron level were associated with the disappearance of the ring, whereas anemia was associated with recurrence. Male sex, age > 35 years, low socioeconomic status, smoking, and both high and low dysphagia were associated with the presence of gastrointestinal cancer. Conclusion: In our setting, SPV primarily affects young women. Despite the effectiveness of endoscopic dilation, the occurrence of recurrences and neoplastic lesions justifies prolonged follow-up.