Síndrome de Plummer-Vinson en un paciente con enfermedad celíaca. Reporte de un caso

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
Oscar Bedini ◽  
Ariel Naves ◽  
Patricia San Miguel ◽  
José Brunetti
Keyword(s):  
Celiac Disease ◽  
Iron Deficiency ◽  
Esophageal Carcinoma ◽  
Iron Deficiency Anemia ◽  
Duodenal Bulb ◽  
Hypochromic Anemia ◽  
Deficiency Anemia ◽  
Esophageal Lumen ◽  
Plummer Vinson Syndrome ◽  
The Relationship

Plummer-Vinson syndrome is infrequent and is more common in middle-aged women. There are few reports of its association with celiac disease. Both entities can be linked to hypochromic anemia and esophageal carcinoma. We report the case of a 47-year-old female patient who, since the age of six, presented frequent episodes of iron deficiency anaemia, having required blood transfusions Eight months before the doctor’s appointment, when she swallowed a tablet, she presented a choking episode due to obstruction. Since then, she has been eating only soft foods. She had iron deficiency anemia, with low ferritin levels. A video swallow performed three months earlier showed a lack of fillong of 2 mm by 7 mm, which obliterated 75% of the esophageal lumen, and another similar image, 2 cm below the first one, arranged in the opposite direction, which obliterated the lumen by 50%. A video endoscopy was performed, which showed two membranes causing stenosis of the lumen in the cricopharyngeal region; they were removed. In the duodenal bulb and second portion, a flattened mucosa was observed, compatible with celiac disease. Biopsies were performed and the anatomopathological diagnosis was highly compatible with celiac disease, Marsh Oberhuber 3B. Conclusion. This observation demonstrates that celiac disease can coexist with Plummer Vinson syndrome. Therefore, it should be investigated in the context of this syndrome, with which it shares the relationship with iron deficiency anemia, and also taking into account the possibility of development of esophageal carcinoma in both entities.

The soluble transferrin receptor (sTfR)-ferritin index is a potential predictor of celiac disease in children with refractory iron deficiency anemia

2005 ◽  
Vol 43 (1) ◽  
Author(s):  
Maurizio De Caterina ◽  
Ernesto Grimaldi ◽  
Giovanni Di Pascale ◽  
Giuliana Salerno ◽  
Assunta Rosiello ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Receptor ◽  
Hematological Parameters ◽  
Deficiency Anemia ◽  
Soluble Transferrin Receptor ◽  
Mean Cell Volume ◽  
Age Range ◽  
Normal Controls

AbstractThe soluble transferrin receptor (sTfR) distinguishes iron deficiency anemia from other types of anemia. Refractory iron deficiency anemia is often the onset symptom in malabsorption-induced celiac disease. We evaluated whether sTfR levels distinguish celiac disease-associated iron deficiency anemia from iron deficiency anemia of other origin. To this aim we measured sTfR and ferritin levels and their ratio (the sTfR/ferritin index) and other hematological parameters in 42 anemic children (20 with and 22 without celiac disease) vs. 22 non-anemic children with celiac disease and 31 healthy controls (age range 4–12years). Hemoglobin parameters, mean cell volume, and serum iron and ferritin levels were decreased to a similar extent in the anemic patients (celiac and non-celiac). The sTfR level in non-anemic celiac patients was similar to that of normal controls (1.7±0.35mg/L), whereas it was significantly increased in non-celiac and celiac anemic patients (2.2±0.5mg/L, p<0.05 and 2.7±1.2mg/L, p<0.001, respectively). The sTfR/ferritin index was also increased more in the anemic celiac patients (mean 4.4, range 1.5–12.0) than in anemic non-celiac children (mean 2.6, range 1.4–4.0) compared with non-anemic children (mean 1.2, range 0.7–2.0). Differences were more pronounced when ferritin was <5ng/mL. Thus, the sTfR/ferritin index may be a predictive measure in discriminating anemic patients with celiac disease from those without celiac disease.

scholarly journals Mothball ingestion as a manifestation of pica, leading to paradichlorobenzene CNS toxicity

2020 ◽  
Vol 20 (2) ◽  
pp. 932-935
Author(s):  
Joon Yau Leong ◽  
Margarita Gianniosis ◽  
Saman Zafar ◽  
Yan Zhang
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Fragile X ◽  
Hypochromic Anemia ◽  
High Index ◽  
Deficiency Anemia ◽  
Neurological Assessment ◽  
Cerebellar Peduncles ◽  
Ataxia Syndrome ◽  
High Index Of Suspicion

Background: Pica is a poorly understood psychiatric disorder that presents with the ingestion of non-nutritious substances for unclear reasons. A high index of suspicion for unusual toxin exposure aids in the diagnosis of pica patients presenting with unexplained neurodegenerative features. Methods: We present a 47-year-old female with worsening gait over the past year. Prior to this, she was fully independent with activities of daily living, but is now mostly housebound due to frequent falls. Past medical history is significant for menorrhagia, iron deficiency anemia and pica. CBC and iron studies revealed iron deficiency with microcytic hypochromic anemia. MRI brain demonstrated symmetrical T2 hyperintensities within the middle cerebellar peduncles. Results: Differential diagnoses for her clinical deficits and imaging, including Spinocerebellar Ataxia, Multiple System At- rophy and Fragile X Tremor-Ataxia Syndrome, were excluded based on neurological assessment, family history and genetic PCR testing. Collateral history revealed a regular habit of mothball ingestion and serum paradichlorobenzene levels were elevated to 15mcg/mL. The patient was treated with iron replacement therapy and her symptoms gradually improved over several months. Conclusion: Iron deficiency anemia is commonly associated with pica, which can lead to toxin ingestion. A high index of suspicion for toxin ingestion in pica patients can immensely aid in the diagnosis. Mothball abuse secondary to pica may affect the CNS and can present with nonspecific neurodegenerative changes. To our knowledge, there have been no reported cases in the literature with paradichlorobenzene neurotoxicity predominantly affecting the middle cerebellar peduncles. Keywords: Mothball; paradichlorobenzene; PDCB; toxicity; pica; middle cerebellar peduncles.

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