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June 1982

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

Author Affiliations

From the Clinical Endocrinology Branch (Drs Morrow and Rosen) and the Arthritis and Rheumatism Branch (Dr Huston), National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases, and the Molecular Disease Branch (Dr Schaefer), National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md. Dr Huston is now with the Baylor College of Medicine, The Methodist Hospital, Houston.

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)