Polyneuropathy organomegaly endocrinopathy M-protein and skin changes syndrome with ascites as an early-stage manifestation:A case report  

作　　者：Xiao-Lei Zhou Ying-Hao Chang Lan Li Juan Ren Xiao-Ling Wu Xue Zhang Peng Wu Shan-Hong Tang 

机构地区：[1]Graduate School,Southwest Medical University,Luzhou 646099,Sichuan Province,China [2]Department of Gastroenterology,General Hospital of Western Theater Command,Chengdu 610083,Sichuan Province,China [3]Department of Infectious Diseases,General Hospital of Western Theater Command,Chengdu 610083,Sichuan Province,China

出　　处：《World Journal of Clinical Cases》2023年第1期135-142,共8页世界临床病例杂志

摘　　要：BACKGROUND Polyneuropathy organomegaly endocrinopathy M-protein and skin changes(POEMS)syndrome is a rare paraneoplastic syndrome caused by a potential plasma cell tumor.The clinical manifestations of POEMS syndrome are diverse.Due to the insidious onset and lack of specific early-stage manifestations,POEMS syndrome is easily misdiagnosed or never diagnosed,leading to delayed treatment.Neurological symptoms are usually the first clinical manifestation,while ascites is a rare symptom in patients with POEMS syndrome.CASE SUMMARY A female patient presented with unexplained ascites as an initial symptom,which is a rare early-stage manifestation of the condition.After 1 year,the patient gradually developed progressive renal impairment,anemia,polyserosal effusion,edema,swollen lymph nodes on the neck,armpits,and groin,and decreased muscle strength of the lower extremities.The patient was eventually diagnosed with POEMS syndrome after multidisciplinary team discussion.Treatment comprised bortezomib+dexamethasone,continuous renal replacement therapy,chest and abdominal closed drainage,transfusions of erythrocytes and platelets,and other symptomatic and supportive treatments.The patient’s condition initially improved after treatment.However,then her symptoms worsened,and she succumbed to the illness and died.CONCLUSION Ascites is a potential early manifestation of POEMS syndrome,and this diagnosis should be considered for patients with unexplained ascites.Furthermore,multidisciplinary team discussion is helpful in diagnosing POEMS syndrome.

关 键 词：Polyneuropathy organomegaly endocrinopathy M-protein and skin changes syndrome ASCITES Early-stage manifestation Neurogenic damage Vascular endothelial growth factor Case report 

分 类 号：R57[医药卫生—消化系统]