Plummer-Vinson syndrome laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Laboratory findings consistent with the diagnosis of Plummer-Vinson syndrome include presence of iron deficiency anemia. Patients suspected of Plummer-Vinson syndrome should be tested with complete blood count (CBC), iron studies, peripheral smear, stool test for occult blood, blood lead levels and bone marrow biopsy for stainable iron.

Laboratory findings consistent with the diagnosis of Plummer-Vinson syndrome include presence of iron deficiency anemia:^{[1][2][3][4][5][6][7][8]}

• Complete blood count (CBC) should be done in patients of Plummer-Vinson syndrome and will have the following findings:
  • Low mean corpuscular volume (MCV <80 fl)
  • Low mean corpuscular hemoglobin concentration (MCHC)
  • Elevated platelet count (platelets > 450,000/µL)
  • Normal or elevated white blood cell count

• Iron studies should be done in patients with pallor, dysphagia or esophageal webs to confirm the diagnosis of Plummer-Vinson syndrome. The tests usually done for iron deficiency anemia are:
  • Serum iron– Decreased in iron deficiency
  • Transferrin– Elevated in iron deficiency
  • Total iron binding capacity (TIBC)- Elevated in iron deficiency
  • Transferrin saturation– derived by dividing the serum iron by the TIBC. Decreased in iron deficiency.
  • Ferritin– Indicator of body iron stores and is low in iron deficiency. However, ferritin also acts as an acute phase reactant and can be unreliable in inflammatory illness.

• Peripheral smear:
  • RBCs are microcytic and hypochromic
  • Increased number of platelets
  • Target cells (can be seen in any case of anemia)

(Images shown below are courtesy of Melih Aktan MD, Istanbul Medical Faculty – Turkey)