Glomeruloid hemangiomas: A marker for POEMS

Abstract

Polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) is a multisystem syndrome that may accompany plasma cell dyscrasias.1,2 Polyneuropathy and a monoclonal plasmaproliferative disorder must be present along with one other minor criterion, including sclerotic bone lesions, Castleman's disease, organomegaly, edema, endocrinopathy, skin changes, or papilledema. Other associated findings may include ascites, pleural effusions, and thrombocytosis. We describe a patient with glomeruloid hemangiomas, a skin abnormality seen exclusively in POEMS.3,4 This has been reported only rarely in the neurologic literature and is a useful diagnostic criterion.5 A 58-year-old woman presented with weakness, distal sensory loss, pain, and edema in the lower extremities. The symptoms had progressed over 3 years. She was using a walker to ambulate. Neurologic examination 3 years earlier, at the time of an episode of low back pain, was normal. She was an obese woman with extensive edema of the extremities and thickening of the skin in the legs and forearms. …