To the Editor.
—We read with interest the report by Hyman and Westrick1 in the May issue of the Archives concerning a patient with the syndrome of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS), and we would like to add some comments with respect to this unique multisystemic syndrome.Although the great majority of patients reported with POEMS syndrome have λlight chains on serum immunoelectrophoresis, patients with κlight chains have also been reported; Nakanishi et al2 recently reviewed the subject and, among 102 cases of what they named the Crow-Fukase syndrome, found three cases with IgA κlight chains and one with IgG K. Additionally, we have had the opportunity to treat a patient with POEMS syndrome in whom serum immunoelectrophoresis disclosed an IgG κ-paraprotein, which was also detected over the atypical bone marrow plasma cells by immunoperoxidase technique.3 Coagulopathy has also been reported in the setting of
Domingo P, Grau E, Ris J, Franco M. Multiple Myeloma With Polyneuropathy and Coagulopathy. Arch Intern Med. 1986;146(10):2089. doi:10.1001/archinte.1986.00360220271053