以慢性免疫功能障碍神经病为发病形式的poems综合征

V. Korotaeva, Y. Kushnir, O. Kudyasheva, A. Polushin, V. Krasnov
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引用次数: 1

摘要

POEMS综合征(多神经病变、器官肿大、内分泌病变、m蛋白、皮肤改变)是一种罕见的与浆细胞异常相关的副肿瘤疾病,其发病机制目前尚不完全清楚。POEMS综合征的诊断通常在发病后较长一段时间后才得到证实,因为该综合征罕见,可被误认为是其他神经系统疾病,例如慢性炎症性脱髓鞘性多神经病变(CIDP)。本文描述了一名年轻男性患者的临床病例,该患者以CIDP临床表型的形式出现神经系统疾病,对一线治疗难治,并进一步出现POEMS综合征的系统性临床和实验室合并症。进行了必要的实验室和放射学检查以确认诊断。根据患者POEMS综合征的2项主要标准、1项附加主要标准和4项次要标准进行诊断。出院后接受血液科医生进一步观察,开始POEMS综合征的基础治疗。在CIDP患者中早期发现POEMS综合征的“危险信号”,可以及时开始治疗,预防进一步的疾病进展和持续致残障碍的发展。关键词:poems综合征,慢性炎症性脱髓鞘性多神经病变,副蛋白,意义不明的单克隆γ病。引文:Korotaeva v.v., Kushnir Ya.B。Kudyasheva O.V.等。以慢性免疫功能障碍神经病为发病形式的poems综合征。俄罗斯医学调查。2022;6(10):589-595(俄文)。DOI: 10.32364 / 2587-6821-2022-6-10-589-595。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
POEMS-syndrome with the disease onset in the form of сhronic dysimmune neuropathy
POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin changes) is a rare paraneoplastic disease associated with plasma cell dyscrasias, the pathogenesis of which is currently not fully understood. The diagnosis of POEMS syndrome is commonly confirmed after an extended period of time from the disease onset, since the syndrome is rare and can be mistaken for other neurological diseases, for instance, chronic inflammatory demyelinating polyneuropathy (CIDP). The article describes a clinical case of the disease in a young male patient with the onset of neurological disorders in the form of the CIDP clinical phenotype, refractory to first-line therapy, and further systemic clinical and laboratory comorbidities of POEMS syndrome. The necessary laboratory and radiological studies were performed to confirm the diagnosis. The diagnosis was established based on the presence of 2 major, 1 additional major and 4 minor criteria of POEMS syndrome in the patient. Then the patient was discharged for further observation of hematologists to initiate basic therapy of POEMS syndrome. Early detection of the POEMS syndrome "red flags" in patients with the CIDP allows for timely treatment initiation, prevention of further disease progression and the development of persistent disabling disorders. KEYWORDS: POEMS-syndrome, chronic inflammatory demyelinating polyneuropathy, paraprotein, monoclonal gammopathy of undetermined significance. FOR CITATION: Korotaeva V.V., Kushnir Ya.B., Kudyasheva O.V. et al. POEMS-syndrome with the disease onset in the form of сhronic dysimmune neuropathy. Russian Medical Inquiry. 2022;6(10):589–595 (in Russ.). DOI: 10.32364/2587-6821-2022-6-10-589-595.
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