Korean J Hematol.  2008 Dec;43(4):253-257. 10.5045/kjh.2008.43.4.253.

A Case of Combined POEMS Syndrome and Multiple Myeloma with Positive M protein Only on Immunofixation

• Yang JH
• Jung JY
• So CS
• Lim YJ
• Han SY
• Park S
• Kim JH
• Hur M
• Lee GK
• Shim JW
• Park YI

• KMID: 1485084
• DOI: http://doi.org/10.5045/kjh.2008.43.4.253

Abstract

POEMS syndrome is a plasma cell proliferative disorder is characterized by the presence of peripheral neuropathy (P), organomegaly (O), monoclonal gammopathy (M), endocrinopathy or edema (E) and skin change (S). It can be rarely related to multiple myeloma. A 48-year-old man was admitted to our hospital due to paresthesia of both inguinal areas and weakness of both lower extremities. He had a history of Castleman's disease, and showed features of polyneuropathy, multiple osteoblastic lesions, hepatosplenomegaly, pretibial pitting edema, and papilledema. The serum and urine electrophoresis were negative, but urine immunofixagion could detect monoclonal protein. Plasmacytoma was confirmed through the biopsy for the osteoblastic lesions. We present a case of combined POEMS syndrome and multiple myeloma with positive M protein only on immunofixation in order to share our experience with physicians and specialists.

Keyword

POEMS syndrome; Multiple myeloma; Osteoblastic lesion

MeSH Terms

Biopsy
Edema
Electrophoresis
Giant Lymph Node Hyperplasia
Humans
Lower Extremity
Middle Aged
Multiple Myeloma
Osteoblasts
Papilledema
Paraproteinemias
Paresthesia
Peripheral Nervous System Diseases
Plasma Cells
Plasmacytoma
POEMS Syndrome
Polyneuropathies
Skin
Specialization

Figure

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  Fig. 1 Pelvic MRI showed multifocal osteoblastic lesions at pelvic bone, sacrum, and L5 (white arrows).

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  Fig. 2 Eccentrically placed nuclei of neoplastic plasma cells with basophilic cytoplasm and a sequestrum (black arrow) (Bone biopsy, H&E stain, ×400, A) and positive staining for λ chain (×400, B).

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