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June 1982

POEMS Syndrome: Studies in a Patient With an IgG-? M Protein but No Polyneuropathy

Arch Intern Med. 1982;142(6):1231-1234. doi:10.1001/archinte.1982.00340190191032

• A 48-year-old woman had a variation of the syndrome of polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (the so-called POEMS syndrome). The patient's neurological findings were entirely normal, but she had splenomegaly, hyperprolactinemia with galactorrhea and oligomenorrhea, a thyroid nodule with evidence of mild thyroiditis on aspiration biopsy specimen, an IgG-κ monoclonal gammopathy, and hyperpigmentation and thickening of the skin. A short course of plasmapheresis (twelve 4-L exchanges in one month) did not alter any of the clinical abnormalities, but did result in a 70% decrease in the monoclonal IgG level (from 2.2 to 0.7 g/dL).

(Arch Intern Med 1982;142:1231-1234)