Disfaji Olan Çocuk Hastalarda Plummer-Vinson Sendromunun Değerlendirilmesi

Year 2024, , 47 - 53, 29.08.2024

Sevinç Garip

https://doi.org/10.47493/abantmedj.1355176

Abstract

Amaç: Disfaji çocukluk çağında sık görülmeye başlanmakta ve birçok nedene bağı olarak gelişmektedir. Çalışmamızda pediatrik çağda disfajinin diğer tüm nedenleri dışlandıktan sonra demir eksikliği anemisi disfaji olan Plummer-Vinson sendromu tanısı ile takip ve tedavi edilen hastalar sunulmaya çalışılmıştır. Amacımız sadece anemi tedavisi ile düzelebilecek disfaji olabileceğini ve çocuk sağlığı ve hastalıkları uzmanı tarafından tedavi ile düzelebileceğini vurgulamaktır.
Materyal ve Metod: Hastanemizde Mayıs 2019 ve Kasım 2020 arasında disfaji şikayeti ile başvuran, disfajinin diğer tüm nedenleri dışlandıktan sonra Plummer-Vinson sendromu tanısı alan hastalar retrospektif olarak değerlendirildi. Hastaların yaş, cinsiyet, disfaji şekli, özelliği ve süresi retrospektif olarak değerlendirilerek literatür eşliğinde sunmak amaçlanmıştır.
Bulgular: Disfaji şikayetiyle başvuran 200 çocuk hastanın 24’ünde PWS saptandı. Hastaların %37,5’u erkek olup, ortalama yaşları 97,5 aydı. Hastaların disfaji şikayet süresi ortalama 11,2 ay olup, 4 hastanın sadece sıvı gıda yutmada zorlanması varken 12 hastada katı, 8 hastada hem katı hem sıvıya karşı yutma güçlüğü mevcuttu. Tam kan sayımı yapılarak ve hemoglobin, hematokrit düzeyleri yaşa uygun 2 standart sapma değerinin altında olanlar anemi; vitamin B12 düzeyi 200 pg/ml değerinin altında olanlar kobalamin eksikliği olarak tanımlandı. Kontraslı özofagografi çekilen 4 hastada özofageal web saptandı. Web saptanan hastaların özofagogastroduodensokopide darlık endoskopik olarak tedavi edildi. Yirmi hastada ise altı aylık demir eksikliği anemi tedavisi sonrası yutma güçlüğünün devam etmediği görüldü.
Sonuç: PVS tanısı çocuklarda nadir görülse de, demir eksikliği anemisi ile ilişkili yutma güçlüğü çeken tüm çocuklarda akla gelmeli ve tedavisi verilmelidir. Uygun dozda ve sürede tedavi sonrası şikayeti devam eden hastalar çocuk gastroenteroloji değerlendirmesi için yönlendirilmelidir.

Keywords

disfaji, çocuk, Plummer-Vinson sendromu, özofageal web, demir eksikliği anemisi

Evaluation Of Plummer-Vinson Syndrome in Pediatric Patients with Dysphagia

Abstract

Aim: In our study, after excluding all other causes of dysphagia in the pediatric age, we tried to present the patients who were followed up and treated with the diagnosis of Plummer-Vinson syndrome(PWS) with iron deficiency anemia and dysphagia. Our aim is to emphasize that there may be dysphagia that can only be cured with anemia treatment and that it can be improved with treatment by a pediatrician.
Material method: Pediatric patients who applied to our hospital with the complaint of dysphagia between May 2019-November 2020 were included in the study. After excluding all other causes of dysphagia, patients diagnosed with PWS were evaluated retrospectively. It was aimed to evaluate the age, gender, type, characteristics and duration of dysphagia of the patients retrospectively and to present them in the light of the literature.
Results: PWS was detected in 24 of 200 pediatric patients who presented with dysphagia. The proportion of male patients was 37.5%, and their mean age was 97 months. The mean duration of dysphagia complaints was 11.2 months. Four patients had difficulty swallowing liquid food only, 12 patients had solid swallowing difficulties, and 8 patients had difficulty swallowing both solid and liquid food. Anemia was diagnosed by performing a complete blood count and having hemoglobin and hematocrit levels below 2 standard deviations appropriate for age; Those with vitamin B12 levels below 200 pg/ml were defined as cobalamin deficiency. Esophageal web was detected in 4 patients who underwent contrast esophagography. In esophagogastroduodensoscopy, stenosis was treated endoscopically in patients with web. In 20 patients, dysphagia did not persist after six months of iron deficiency anemia treatment.
Conclusion: Although the diagnosis of PVS is rare in children, it should be considered and treated in all children with dysphagia associated with iron deficiency anemia. Patients whose complaints continue after treatment at the appropriate dose and duration should be referred for pediatric gastroenterology evaluation.

Keywords

child, Plummer-Vinson syndrome, iron-deficiency anemia, esophageal web, dysafgia

Ethical Statement

Ethics Committee Approval: The study was approved by Adana city training and research hospital clinical research ethics committee (approval date: 17.08.2023, meeting number: 133, decision no: 2772).

Supporting Institution

Yok

Thanks

Acknowledgement: We would like to thank the Pediatric Health and Diseases Clinic staff who contributed to the diagnosis and treatment processes of the patients who participated in the relevant study.

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