• 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)
Jay S. Morrow, Ernst J. Schaefer, David P. Huston, Saul W. Rosen. POEMS SyndromeStudies 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