Plummer–Vinson syndrome is a rare disease characterized by difficulty swallowing, iron-deficiency anemia, glossitis, cheilosis and esophageal webs. Treatment with iron supplementation and mechanical widening of the esophagus generally provides an excellent outcome. While exact data about the epidemiology is unknown, this syndrome has become extremely rare. The reduction in the prevalence of Plummer–Vinson syndrome has been hypothesized to be the result of improvements in nutritional status and availability in countries where the syndrome was previously described. It generally occurs in perimenopausal women. Its identification and follow-up is considered relevant due to increased risk of squamous cell carcinomas of the esophagus and pharynx. Presentation Patients with Plummer–Vinson syndrome often have a burning sensation with the tongue and oral mucosa, and atrophy of lingual papillae produces a smooth, shiny, red, dorsum of the tongue. Symptoms include: Dysphagia (difficulty swallowing) Pain Weakness Odynophagia (painful swallowing) Atrophic glossitis Angular cheilitis Koilonychia (Abnormally thin nails, also called spoon nails) Splenomegaly (an enlarged spleen). Upper esophageal webs (post cricoid region - contrasts with Schatzki rings found at the lower end of esophagus). Serial contrasted gastrointestinal radiography or upper-gastrointestinal endoscopy may reveal the web in the esophagus. Blood tests demonstrate a hypochromic microcytic anemia that is consistent with an iron-deficiency anemia. Biopsy of involved mucosa typically reveals epithelial atrophy (shrinking) and varying amounts of submucosal chronic inflammation. Epithelial atypia or dysplasia may be present. It may also present as a post-cricoid malignancy which can be detected by loss of laryngeal crepitus. Laryngeal crepitus is found normally and is produced because the cricoid cartilage rubs against the vertebrae. Causes The cause of Plummer–Vinson syndrome is unknown; however, genetic factors and nutritional deficiencies may play a role. It is more common in women, particularly in middle age, with a peak age over 50 years. Diagnosis The following clinical presentations may be used in the diagnosis of this condition. Dizziness Pallor of the conjunctiva and face Erythematous oral mucosa with burning sensation Breathlessness Atrophic and smooth tongue Peripheral rhagades around the oral cavity The following tests are helpful in the diagnosis of Plummer–Vinson syndrome. Lab tests Complete blood cell counts, peripheral blood smears, and iron studies (e.g., serum iron, total iron-binding capacity, ferritin, and saturation percentage) to confirm iron deficiency, either with or without hypochromic microcytic anemia. Imaging Barium esophagography and videofluoroscopy will help to detect esophageal webs. Esophagogastroduodenoscopy will enable visual confirmation of esophageal webs. The webs occur due