Multiple myeloma with polyneuropathy and coagulopathy. A case report of the polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin change (POEMS) syndrome.

Abstract

A patient with the syndrome of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) had multiple myeloma and IgA-kappa monoclonal gammopathy. To our knowledge, of over 50 cases in the literature, this is the only instance of kappa light chains noted in a patient with the complete syndrome. Sural nerve biopsy revealed increased immunofluorescence for IgA and kappa 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.

• Authors: B T Hyman, M A Westrick
• Journal: Archives of internal medicine (Arch Intern Med) Vol. 146 Issue 5 Pg. 993-4 (May 1986) ISSN: 0003-9926 [Print] United States
• PMID: 3083799 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulin Light Chains
• Immunoglobulin kappa-Chains
• Myeloma Proteins

Topics

• Blood Coagulation Disorders (complications)
• Humans
• Immunoglobulin Light Chains (immunology)
• Immunoglobulin kappa-Chains (immunology)
• Male
• Middle Aged
• Multiple Myeloma (complications)
• Myeloma Proteins (blood)
• Paraproteinemias (complications)
• Polyneuropathies (complications)
• Skin Diseases (complications)
• Syndrome