Six-year course of POEMS Syndrome: a case report

Abstract

We reported a case of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome diagnosed 6 years after the onset of the initial symptoms, when all the typical features had finally developed. The patient was a 54-year-old woman who initially presented with tonsillitis and enlarged cervical lymph nodes, and was treated with tonsillectomy and lymph node resection. Three years later, she presented with recurrent cervical lymphadenopathies (diagnosed as Castleman's disease), multiple osteoblastic lesions, and weakness of both lower extremities. After another three years without adequate treatment, the patient showed progressive limb weakness (which proved to be polyneuropathy), generalized edema, splenomegaly, and hypertrichosis. We performed serum electrophoresis, and its findings indicated immunoglobulin G (IgG) monoclonal gammopathy, which finally established a diagnosis of POEMS syndrome. In this report, we provide a brief review of POEMS syndrome and a critical retrospective evaluation of the delay in diagnosis of this patient.