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A Case Report of the Polyneuropathy, Organomegaly, Endocrinopathy, M-Protein, and Skin Change (POEMS) Syndrome

Bradley T. Hyman, MD, PhD; Mary Alice Westrick, MD

Arch Intern Med. 1986;146(5):993-994.

Abstract
• A patient with the syndrome of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) had multiple myeloma and IgA- monoclonal gammopathy. To our knowledge, of over 50 cases in the literature, this is the only instance of light chains noted in a patient with the complete syndrome. Sural nerve biopsy revealed increased immunofluorescence for IgA and chains. Furthermore, this patient had a hemorrhagic diathesis characterized by a prolonged bleeding time and a prolonged thrombin time due to a qualitative platelet dysfunction and an apparent inhibition of fibrin monomer polymerization. In none of the other cases of POEMS syndrome was a coagulopathy reported. A short course of plasmapheresis improved the bleeding time but did not alter the polyneuropathy.

(Arch Intern Med 1986;146:993-994)

Author Affiliations
From the Departments of Neurology (Dr Hyman) and Internal Medicine (Dr Westrick), University of Iowa College of Medicine, Iowa City.

Footnotes
Accepted for publication Dec 9, 1985.

Reprint requests to Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA 52242 (Dr Westrick).

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