Presentation
In the present series, median survival was 165 months. [bloodjournal.hematologylibrary.org]
The patient died due to multisystem complications nine months after presenting with acute on chronic renal failure. [ncbi.nlm.nih.gov]
Entire Body System
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Fatigue
Five months later, the patient started to have lower extremity numbness and fatigue. Initial laboratory tests did not reveal positive monoclonal immunoglobulin. [ncbi.nlm.nih.gov]
We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 31, 2019 [patientslikeme.com]
Abnormal hormone levels that can result in underactive thyroid (hypothyroidism), diabetes, sexual problems, fatigue, swelling in your limbs, and problems with metabolism and other essential functions. Monoclonal plasmaproliferative disorder. [mayoclinic.org]
Abnormal hormone levels that can result in underactive thyroid gland, diabetes, sexual problems, fatigue, swelling in your limbs and problems with metabolism and other essential functions. Monoclonal plasma-proliferative disorder. [humanitas.net]
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Soft Tissue Mass
We present three cases of POEMS syndrome manifesting as osteolytic lesions with indolent features, including well-defined thin sclerotic rims, no cortical disruption or periosteal reaction, no associated soft-tissue mass, and a periarticular location, [ncbi.nlm.nih.gov]
Gastrointestinal
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Acute Abdomen
We present a 54-year-old woman from Sri Lanka with POEMS syndrome who experienced recurrent ischemic strokes followed by an acute abdomen and global heart failure. [ncbi.nlm.nih.gov]
Eyes
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Retinal Hemorrhage
Retinal manifestations included retinal hemorrhage, subretinal fluid, macular edema, and cotton wool spot. The difference in mean serum VEGF concentrations between patients with and without ODE was significant (P 0.017). [ncbi.nlm.nih.gov]
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Cotton Wool Spots
Retinal manifestations included retinal hemorrhage, subretinal fluid, macular edema, and cotton wool spot. The difference in mean serum VEGF concentrations between patients with and without ODE was significant (P 0.017). [ncbi.nlm.nih.gov]
Skin
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Hypertrichosis
Links: polyneuropathy hepatosplenomegaly gynaecomastia secondary amenorrhoea diabetes mellitus hyperpigmentation hypertrichosis osteosclerotic myeloma [gpnotebook.co.uk]
Cutaneous manifestations are heterogeneous, with diffuse cutaneous hyperpigmentation, hemangiomas and hypertrichosis occurring more frequently. [ncbi.nlm.nih.gov]
Neurologic
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Intracranial Hemorrhage
Izumi Yamaguchi, Junichiro Satomi, Nobuaki Yamamoto, Shotaro Yoshioka, Yoshiteru Tada, Kenji Yagi, Yasuhisa Kanematsu and Shinji Nagahiro, Coexistence of Quasi-moyamoya Disease and POEMS Syndrome in a Patient with Intracranial Hemorrhage: A Case Report [doi.org]
Workup
An extensive diagnostic workup revealed POEMS syndrome. Serum concentrations of vascular endothelial growth factor (VEGF) were highly elevated, consistent with POEMS syndrome. [ncbi.nlm.nih.gov]
Some may present with known history of a specific monoclonal gammopathy, while in others, boney lesions of osteomyeloma or other evidence of a plasma cell dyscrasia are detected during workup for POEMS in patients with neuropathy. [dermatologyadvisor.com]
X-Ray
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Right Pleural Effusion
CT showed a massive right pleural effusion and a sclerotic lesion in the right ninth rib. Histopathological examination of the rib revealed IgA lambda-type plasmacytoma. Serum vascular endothelial growth factor was extremely high at 5530 pg/mL. [ncbi.nlm.nih.gov]
Serum
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Thrombocytosis
In addition to peripheral neuropathy, the presence of hepatosplenomegaly, skin changes, polycythaemia and thrombocytosis prompted for further investigations. [ncbi.nlm.nih.gov]
Biopsy
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Liver Biopsy
The liver biopsy suggested hepatoportal sclerosis, compatible with idiopathic portal hypertension (IPH). Under a band ligation program, with beta-blocker, diuretics and prophylactic anticoagulation, the patient remains stable. [ncbi.nlm.nih.gov]
Treatment
Forty-one treatment-naive patients were enrolled from April 2014 to November 2014. [ncbi.nlm.nih.gov]
Some patients progress after radiation therapy and require systemic treatment. Alkylators are the main treatment, along with lenalidomide and to a lesser extent thalidomide and bortezomib. [orpha.net]
Prognosis
Abstract POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes) is a multisystem disorder with a good long-term prognosis. [ncbi.nlm.nih.gov]
Prognosis The prognosis is generally good if diagnosis is early and appropriate treatment is provided. Causes of death include progressive anasarca, thrombosis, and inanition. [orpha.net]
New agents and new application of stem-cell transplantation have dramatically improved outcomes for these previously uniformly poor prognosis disorders. [mayoclinic.pure.elsevier.com]
Etiology
Although the etiology of ONJ is not known, it is likely that several factors are at play, including endothelial cell damage, decreased angiogenesis, and microvascular compromise. [ncbi.nlm.nih.gov]
Etiology not established, likely secondary to imbalance of inflammatory cytokines. [ajnr.org]
Epidemiology
Summary Epidemiology Exact prevalence and incidence rates are not known. The only estimates are from Japan. In this country, prevalence has been reported to be about 1/330,000. Male predilection has been reported (2.5:1). [orpha.net]
[…] hyperplasia, 11 - 30% of cases, most commonly multicentric Castleman disease) Terminology POEMS acronym coined in 1980 by Bardwick et al. ( Medicine (Baltimore) 1980;59:311 ) Other names: osteosclerotic myeloma, Takatsuki syndrome, Crow-Fukase syndrome Epidemiology [pathologyoutlines.com]
The epidemiologic and clinical characteristics of the patients are summarized in Table 1. [jamanetwork.com]
Review article: portal vein obstruction–epidemiology, pathogenesis, natural history, prognosis and treatment. Aliment Pharmacol Ther 2015; 41: 276-292. Ganti AK, Pipinos I, Culcea E, Armitage JO, Tarantolo S. [actagastro.org]
Epidemiology Frequency POEMS syndrome is rare. Several hundred cases have been described in the literature; however, the incidence may be underreported because the syndrome may go unrecognized. [emedicine.com]
Pathophysiology
Vascular endothelial growth factor (VEGF) plays an essential role in the pathophysiology of polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes (POEMS) syndrome. [ncbi.nlm.nih.gov]
Pathophysiology The pathophysiology of POEMS syndrome is not well understood. In all patients, a plasma cell disorder underlies the development of the syndrome; however, the mechanism by which this occurs is unknown. [emedicine.com]
Prevention
It is clear that attention needs to be paid to prevent bacterial, fungal and viral infection after HSCT. It is also important to keep in mind that tuberculous and nontuberculous mycobacteria (NTM), in rare cases, lead to lethal complications. [ncbi.nlm.nih.gov]
Clinical trials Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease. POEMS syndrome care at Mayo Clinic June 23, 2017 Rajkumar SV. POEMS syndrome. . [mayoclinic.org]
Paba-Prada explained that the best way to prevent a relapse is a stem cell transplant using my own cells,” Anyanwu relates. [blog.dana-farber.org]
Michael Tomasson, Mahmoud Ali, Vanessa De Oliveira, Qian Xiao, Yogesh Jethava, Fenghuang Zhan, Adam Fitzsimmons and Melissa Bates, Prevention Is the Best Treatment: The Case for Understanding the Transition from Monoclonal Gammopathy of Undetermined Significance [doi.org]