Síndrome de POEMS en un hombre de 36 años: reporte de caso

Abstract

Case presentation

We report a case of a 36 year old man who presented with paresis of the lower extremities that limited gait and blurred vision. The diagnosis of peripheral polyradiculopathy and papilledema was established. Apart from clinic findings, using laboratory and imaging studies, splenomegaly, plasmacytic myeloma of the left sacroiliac joint, elevation of IgM and hyperthyroidism were demonstrated. The patient was managed with corticosteroids, radiation therapy, anti-thyroid drugs, and physical rehabilitation.

Discussions

Since there is no single test that establishes the diagnosis, different signs and symptoms that must be put together to be able to diagnose polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. In this case, the patient fulfilled the new diagnostic criteria for this syndrome. Compared to the usual presentation of this nosological entity, it must be mentioned that unlike previous reports, this patient did not present with sensitivity changes, and the elevated immunoglobulin was IgM, in contrast to previous cases, in which the main increase was in IgA or IgG.

Conclusions

This syndrome is a multisystemic disease that is difficult to diagnose because of the long period of time that the different signs and symptoms take to manifest themselves.