In a recent issue of the ARCHIVES, Kang et al1 brought to our attention the risk of cerebrovascular events in patients with POEMS syndrome, a multisystem disorder characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. Thrombotic events were observed and appear to be part of the syndrome. The association with cerebrovascular disease has received little attention; most case reports refer to involvement of the coronary and lower limb arteries.2 The report by Kang and colleagues is surely welcome to improve the knowledge of this rare syndrome. The authors found an elevated fibrinogen level in all of their patients. They suggest that this may play a role in the pathogenesis of stroke in patients with POEMS.
Di Napoli M, Arakelyan A. POEMS Syndrome, Fibrinogen, and Ischemic Stroke: A Critical Point of View. Arch Neurol. 2004;61(1):155. doi: