Andy
Senior Member (Voting rights)
Abstract
A woman in her 40s, with a history of childhood paralytic poliomyelitis, presented with progressive difficulty swallowing, fatigue and unintended weight loss. Due to her limited mobility and chronic tiredness, the diet gradually became restricted, lacking iron, vitamin B12, calcium and protein. She frequently skipped meals and avoided nutrient-dense foods. Clinical signs pointed to multinutrient deficiency, and laboratory results confirmed iron deficiency anaemia along with other deficiencies. Upper gastrointestinal endoscopy revealed a postcricoid oesophageal web, consistent with Plummer–Vinson syndrome (PVS). The web was successfully dilated, and she was started on targeted nutritional therapy, including iron, B12 and calcium supplementation. Her symptoms improved significantly over the following weeks, with better swallowing, energy and nutritional status. This case highlights a rare intersection of postpolio neuromuscular sequelae and nutritional deficiency as a contributing pathway to secondary PVS, reinforcing the need for thorough dietary assessment in patients with physical disability and dysphagia.Paywall