A 42-year-old woman reports difficulty swallowing solid food, sore tongue, and brittle nails. Examination shows glossitis, angular stomatitis, and spoon-shaped nails. Hemoglobin is 8.9 g/dL, MCV 68 fL, ferritin 5 ng/mL. Barium swallow reveals a thin mucosal web in the upper esophagus. What is the diagnosis?
- A Plummer-Vinson syndrome ✓
- B Achalasia cardia
- C Schatzki ring
- D Eosinophilic esophagitis
Correct answer: A. Plummer-Vinson syndrome
Explanation
The triad of iron deficiency anemia, upper esophageal web, and dysphagia defines Plummer-Vinson (Paterson-Kelly) syndrome, typically in middle-aged women, often with glossitis and koilonychia. The key distinguishing point from a Schatzki ring is location: the web is cervical or upper esophageal, whereas a Schatzki ring is a lower esophageal mucosal ring at the squamocolumnar junction. These patients carry an increased risk of postcricoid squamous cell carcinoma.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.