Journal of Medical Sciences and Health Care Research
Recurrent Cervical Lymphadenopathy with Peripheral Neuropathy A Case Report of POEMS syndrome
Abstract
Hafeja Akhter Hima, Raihan Rotap Khan, Sayedatus saba, Habibur Rahman Tarek, Mohiuddin Mohammad Alamgir and Md. Rezaur Rahman
POEMS syndrome, which stands for polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes, is a rare type of demyelinating neuropathy associated with plasma cell disorders and increased levels of vascular endothelial growth factor (VEGF). This syndrome is a severely debilitating and often fatal condition. The progressive nature of polyneuropathy can lead to tetraplegia, as well as significant pleural effusions and ascites, ultimately resulting in multiorgan failure. The unusual presentation of these symptoms might lead any physician to consider alternative diagnoses. We present the case of a 60-year-old man diagnosed with POEMS syndrome, initially presenting with polyneuropathy and cervical lymphadenopathy. Early confirmation of the diagnosis proved challenging since initial biochemical tests returned normal results; however, a biopsy of the cervical lymph nodes indicated Castleman’s disease. Ultimately, the diagnosis was confirmed through the detection of monoclonal immunoglobulin via serum protein electrophoresis, nerve conduction studies, and the presence of additional clinical features. The patient was diagnosed with POEMS syndrome and underwent treatment with Melphalan combined with dexamethasone, resulting in a positive outcome.