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id="toc-Skin_changes" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Skin_changes"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.4</span> <span>Skin changes</span> </div> </a> <ul id="toc-Skin_changes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Papilledema" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Papilledema"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.5</span> <span>Papilledema</span> </div> </a> <ul id="toc-Papilledema-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hematological_alterations" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Hematological_alterations"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.6</span> <span>Hematological alterations</span> </div> </a> <ul id="toc-Hematological_alterations-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li 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</li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" 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href="https://de.wikipedia.org/wiki/POEMS-Syndrom" title="POEMS-Syndrom – German" lang="de" hreflang="de" data-title="POEMS-Syndrom" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/S%C3%ADndrome_POEMS" title="Síndrome POEMS – Spanish" lang="es" hreflang="es" data-title="Síndrome POEMS" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Syndrome_POEMS" title="Syndrome POEMS – French" lang="fr" hreflang="fr" data-title="Syndrome POEMS" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Sindrome_POEMS" title="Sindrome POEMS – Italian" lang="it" hreflang="it" data-title="Sindrome POEMS" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/POEMS_sindromas" title="POEMS sindromas – Lithuanian" lang="lt" hreflang="lt" data-title="POEMS sindromas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%82%AF%E3%83%AD%E3%82%A6%E3%83%BB%E6%B7%B1%E7%80%AC%E7%97%87%E5%80%99%E7%BE%A4" title="クロウ・深瀬症候群 – Japanese" lang="ja" hreflang="ja" data-title="クロウ・深瀬症候群" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/POEMS_syndrom" title="POEMS syndrom – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="POEMS syndrom" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Zesp%C3%B3%C5%82_POEMS" title="Zespół POEMS – Polish" lang="pl" hreflang="pl" data-title="Zespół POEMS" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q2553422#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div 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.hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"POEMS" redirects here. For other uses, see <a href="/wiki/Poetry_(disambiguation)" class="mw-disambig" title="Poetry (disambiguation)">Poetry (disambiguation)</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Paraneoplastic syndrome</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">POEMS syndrome</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Crow–Fukase syndrome, Osteosclerotic myeloma, PEP syndrome, Polyneuropathy-endocrinopathy-plasma cell dyscrasia syndrome, Takatsuki syndrome.<sup id="cite_ref-rarediseases_1-0" class="reference"><a href="#cite_note-rarediseases-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span typeof="mw:File"><a href="/wiki/File:Plasma_cells.jpg" class="mw-file-description" title="Plasma cells"><img alt="Plasma cells" src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e2/Plasma_cells.jpg/250px-Plasma_cells.jpg" decoding="async" width="250" height="188" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e2/Plasma_cells.jpg/375px-Plasma_cells.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e2/Plasma_cells.jpg/500px-Plasma_cells.jpg 2x" data-file-width="1024" data-file-height="768" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Multiple_myeloma" title="Multiple myeloma">Multiple myeloma</a> is usually diagnosed because <a href="/wiki/Malignant" class="mw-redirect" title="Malignant">malignant</a> <a href="/wiki/Plasma_cells" class="mw-redirect" title="Plasma cells">plasma cells</a> continue to produce an antibody that can be detected as a <a href="/wiki/Paraprotein" class="mw-redirect" title="Paraprotein">paraprotein</a>.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Oncology" title="Oncology">Oncology</a> <span class="penicon autoconfirmed-show"><span class="mw-valign-text-top" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q2553422?uselang=en#P1995" title="Edit this on Wikidata"><img alt="Edit this on Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><a href="/wiki/Papilledema" title="Papilledema">Papilledema</a>,<sup id="cite_ref-pmid21035860_2-0" class="reference"><a href="#cite_note-pmid21035860-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Polyneuropathy" title="Polyneuropathy">polyneuropathy</a>,<sup id="cite_ref-rarediseases_1-1" class="reference"><a href="#cite_note-rarediseases-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Edema" title="Edema">edema</a>,<sup id="cite_ref-pmid28299525_3-0" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ajh_4-0" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Hyperpigmentation" title="Hyperpigmentation">hyperpigmentation</a>, <a href="/wiki/Hypogonadism" title="Hypogonadism">hypogonadism</a>,<sup id="cite_ref-rarediseases_1-2" class="reference"><a href="#cite_note-rarediseases-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Organomegaly" title="Organomegaly">visceromegaly</a>,<sup id="cite_ref-rarediseases_1-3" class="reference"><a href="#cite_note-rarediseases-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Amenorrhea" title="Amenorrhea">amenorrhea</a>,<sup id="cite_ref-pmid28299525_3-1" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ajh_4-1" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Gynecomastia" title="Gynecomastia">gynecomastia</a>,<sup id="cite_ref-pmid28299525_3-2" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ajh_4-2" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Erectile_dysfunction" title="Erectile dysfunction">erectile dysfunction</a>,<sup id="cite_ref-pmid28299525_3-3" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ajh_4-3" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Testicular_atrophy" title="Testicular atrophy">testicular atrophy</a>.<sup id="cite_ref-pmid28299525_3-4" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ajh_4-4" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Multiple_organ_dysfunction_syndrome" title="Multiple organ dysfunction syndrome">Multiorgan failure</a>, <a href="/wiki/Restrictive_lung_disease" title="Restrictive lung disease">restrictive lung disease</a>, <a href="/wiki/Pulmonary_hypertension" title="Pulmonary hypertension">pulmonary hypertension</a>, <a href="/wiki/Respiratory_arrest" title="Respiratory arrest">cardiorespiratory failure</a>, <a href="/wiki/Starvation" title="Starvation">progressive inanition</a>, <a href="/wiki/Infection" title="Infection">infection</a>, <a href="/wiki/Capillary_leak_syndrome" title="Capillary leak syndrome">capillary leak-like syndrome</a>, and <a href="/wiki/Kidney_failure" title="Kidney failure">renal failure</a>.<sup id="cite_ref-mjhid_5-0" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">5th to 6th decade of life.<sup id="cite_ref-medscape_6-0" class="reference"><a href="#cite_note-medscape-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">Chronic.<sup id="cite_ref-medscape_6-1" class="reference"><a href="#cite_note-medscape-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Clinical Criteria.<sup id="cite_ref-medscape_6-2" class="reference"><a href="#cite_note-medscape-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Chronic_inflammatory_demyelinating_polyneuropathy" title="Chronic inflammatory demyelinating polyneuropathy">Chronic inflammatory demyelinating polyradiculoneuropathy</a>, <a href="/wiki/Cryoglobulinemia" title="Cryoglobulinemia">cryoglobulinemia</a>, <a href="/wiki/Amyloidosis" title="Amyloidosis">nodular localized cutaneous amyloidosis</a>, <a href="/wiki/Multiple_myeloma" title="Multiple myeloma">multiple myeloma</a>, <a href="/wiki/Monoclonal_gammopathy_of_undetermined_significance" title="Monoclonal gammopathy of undetermined significance">monoclonal gammopathy of undetermined significance</a>, <a href="/wiki/Waldenstr%C3%B6m_macroglobulinemia" title="Waldenström macroglobulinemia">waldenstrom hypergammaglobulinemia</a>, <a href="/wiki/Scleroderma" title="Scleroderma">scleroderma</a>, <a href="/wiki/Raynaud_phenomenon" class="mw-redirect" title="Raynaud phenomenon">raynaud phenomenon</a>, <a href="/wiki/AL_amyloidosis" title="AL amyloidosis">amyloid light chains (AL) amyloidosis</a>, <a href="/wiki/Guillain%E2%80%93Barr%C3%A9_syndrome" title="Guillain–Barré syndrome">guillain-Barré syndrome</a>.<sup id="cite_ref-medscape_6-3" class="reference"><a href="#cite_note-medscape-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-nord_7-0" class="reference"><a href="#cite_note-nord-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Corticosteroid" title="Corticosteroid">Corticosteroids</a>, low-dose alkylators, peripheral <a href="/wiki/Hematopoietic_stem_cell_transplantation" title="Hematopoietic stem cell transplantation">blood stem cell transplantation</a>, high-dose <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>.<sup id="cite_ref-medscape_6-4" class="reference"><a href="#cite_note-medscape-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data"><a href="/wiki/Thalidomide" title="Thalidomide">Thalidomide</a>, <a href="/wiki/Lenalidomide" title="Lenalidomide">lenalidomide</a>, <a href="/wiki/Bortezomib" title="Bortezomib">bortezomib</a>, <a href="/wiki/Bevacizumab" title="Bevacizumab">bevacizumab</a>.<sup id="cite_ref-mjhid_5-1" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">Median survival of 13.8 years.<sup id="cite_ref-ashpub_8-0" class="reference"><a href="#cite_note-ashpub-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">Rare</td></tr></tbody></table> <p><b>POEMS syndrome</b> (also termed <b>osteosclerotic myeloma</b>, <b>Crow–Fukase syndrome, Takatsuki disease</b>, or <b>PEP syndrome</b>) is a <a href="/wiki/Rare_disease" title="Rare disease">rare</a> <a href="/wiki/Paraneoplastic" class="mw-redirect" title="Paraneoplastic">paraneoplastic</a> <a href="/wiki/Syndrome" title="Syndrome">syndrome</a> caused by a <a href="/wiki/Clone_(cell_biology)" title="Clone (cell biology)">clone</a> of aberrant <a href="/wiki/Plasma_cell" title="Plasma cell">plasma cells</a>. The name POEMS is an <a href="/wiki/Acronym" title="Acronym">acronym</a> for some of the disease's major <a href="/wiki/Medical_sign" class="mw-redirect" title="Medical sign">signs</a> and <a href="/wiki/Symptom" class="mw-redirect" title="Symptom">symptoms</a> (<a href="/wiki/Polyneuropathy" title="Polyneuropathy"><b>p</b>olyneuropathy</a>, <a href="/wiki/Organomegaly" title="Organomegaly"><b>o</b>rganomegaly</a>, <a href="/wiki/Endocrinopathy" class="mw-redirect" title="Endocrinopathy"><b>e</b>ndocrinopathy</a>, <a href="/wiki/Myeloma_protein" title="Myeloma protein"><b>m</b>yeloma protein</a>, and <a href="/wiki/Cutaneous_condition" class="mw-redirect" title="Cutaneous condition"><b>s</b>kin changes</a>), as is PEP (<a href="/wiki/Polyneuropathy" title="Polyneuropathy"><b>p</b>olyneuropathy</a>, <a href="/wiki/Endocrinopathy" class="mw-redirect" title="Endocrinopathy"><b>e</b>ndocrinopathy</a>, <a href="/wiki/Plasma_cell_dyscrasia" class="mw-redirect" title="Plasma cell dyscrasia"><b>p</b>lasma cell dyscrasia</a>). </p><p>The signs and symptoms of most <a href="/wiki/Neoplasms" class="mw-redirect" title="Neoplasms">neoplasms</a> are due to their <a href="/wiki/Mass_effect_(medicine)" title="Mass effect (medicine)">mass effects</a> caused by the invasion and destruction of tissues by the <a href="/wiki/Neoplasm" title="Neoplasm">neoplasms</a>' cells. Signs and symptoms of a cancer causing a <a href="/wiki/Paraneoplastic_syndrome" title="Paraneoplastic syndrome">paraneoplastic syndrome</a> result from the release of <a href="/wiki/Humoral" class="mw-redirect" title="Humoral">humoral</a> factors such as <a href="/wiki/Hormone" title="Hormone">hormones</a>, <a href="/wiki/Cytokine" title="Cytokine">cytokines</a>, or <a href="/wiki/Immunoglobulins" class="mw-redirect" title="Immunoglobulins">immunoglobulins</a> by the syndrome's <a href="/wiki/Neoplasm" title="Neoplasm">neoplastic cells</a> and/or the response of the <a href="/wiki/Immune_system" title="Immune system">immune system</a> to the <a href="/wiki/Neoplasm" title="Neoplasm">neoplasm</a>. Many of the signs and symptoms in POEMS syndrome are due at least in part to the release of an aberrant <a href="/wiki/Antibody" title="Antibody">immunoglobulin</a>, i.e. a <a href="/wiki/Myeloma_protein" title="Myeloma protein">myeloma protein</a>, as well as certain <a href="/wiki/Cytokine" title="Cytokine">cytokines</a> by the <a href="/wiki/Malignancy" title="Malignancy">malignant</a> <a href="/wiki/Plasma_cell" title="Plasma cell">plasma cells</a>.<sup id="cite_ref-pmid27866585_9-0" class="reference"><a href="#cite_note-pmid27866585-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid28299525_3-5" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ajh_4-5" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>POEMS syndrome typically begins in middle age – the average age at onset is 50 – and affects up to twice as many men as women. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The signs and symptoms of POEMS syndrome are highly variable. This often leads to long delays (e.g. 13–18 months) between the onset of initial symptoms and diagnosis.<sup id="cite_ref-pmid27866585_9-1" class="reference"><a href="#cite_note-pmid27866585-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid28299525_3-6" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> In addition to the signs and symptoms indicated by the POEMS acronym, the PEST acronym is used to describe some of the other signs and symptoms of the disease. PEST stands for <a href="/wiki/Papilledema" title="Papilledema"><b>P</b>apilledema</a>, evidence of <b>E</b>xtravascular volume overload (<a href="/wiki/Ascites" title="Ascites">ascites</a>, <a href="/wiki/Pleural_effusion" title="Pleural effusion">pleural effusion</a>, <a href="/wiki/Pericardial_effusion" title="Pericardial effusion">pericardial effusion</a>, and lower extremity <a href="/wiki/Edema" title="Edema">edema</a>), <a href="/wiki/Bone_metastasis#Diagnosis" title="Bone metastasis"><b>S</b>clerotic bone lesions</a>, and <a href="/wiki/Thrombocytosis" class="mw-redirect" title="Thrombocytosis"><b>T</b>hrombocytosis</a>/<a href="/wiki/Erythrocytosis" class="mw-redirect" title="Erythrocytosis">erythrocytosis</a> (i.e. increased in blood <a href="/wiki/Platelets" class="mw-redirect" title="Platelets">platelets</a> and <a href="/wiki/Erythrocytes" class="mw-redirect" title="Erythrocytes">red blood cells</a>). Other features of the disease include a tendency toward <a href="/wiki/Leukocytosis" title="Leukocytosis">leukocytosis</a>, <a href="/wiki/Thrombosis" title="Thrombosis">blood clot formation</a>, abnormal lung function (<a href="/wiki/Restrictive_lung_disease" title="Restrictive lung disease">restrictive lung disease</a>, <a href="/wiki/Pulmonary_hypertension" title="Pulmonary hypertension">pulmonary hypertension</a>, and <a href="/wiki/Diffusion_capacity" class="mw-redirect" title="Diffusion capacity">impaired lung diffusion capacity</a>), very high blood levels of the <a href="/wiki/Cytokine" title="Cytokine">cytokine</a> <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">vascular endothelial growth factor (VEGF)</a>, and an overlap with the signs and symptoms of multicentric <a href="/wiki/Castleman_disease" title="Castleman disease">Castleman disease</a>.<sup id="cite_ref-pmid28299525_3-7" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Common_features">Common features</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=2" title="Edit section: Common features"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The more common features of the disease are summarized in the acronym POEMS: <b><a href="/wiki/Papilledema" title="Papilledema">Papilledema</a></b> (swelling of the <a href="/wiki/Optic_disc" title="Optic disc">optic disc</a>) often but not always due to increased <a href="/wiki/Intracranial_pressure" title="Intracranial pressure">intracranial pressure</a>) is the most common ocular sign of POEMS syndrome, occurring in ≥29% of cases. Less frequent ocular findings include <a href="/wiki/Cystoid_macular_edema" class="mw-redirect" title="Cystoid macular edema">cystoid macular edema</a>, <a href="/wiki/Retinal_detachment#Types" title="Retinal detachment">serous macular detachment</a>, <a href="/wiki/Idiopathic_orbital_inflammatory_disease" title="Idiopathic orbital inflammatory disease">infiltrative orbitopathy</a>, and venous sinus thrombosis.<sup id="cite_ref-pmid21035860_2-1" class="reference"><a href="#cite_note-pmid21035860-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Some features have been observed in patients with POEMS syndrome but are not yet certain to form part of the syndrome itself. These include <a href="/wiki/Thrombophilia" title="Thrombophilia">a predisposition to forming blood clots</a>, <a href="/wiki/Arthralgia" title="Arthralgia">joint pain</a>, <a href="/wiki/Cardiomyopathy" title="Cardiomyopathy">cardiomyopathy</a> (systolic dysfunction), <a href="/wiki/Fever" title="Fever">fever</a>, low <a href="/wiki/Vitamin_B12" title="Vitamin B12">vitamin B12</a> levels, and <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a>.<sup id="cite_ref-Dispenzieri_10-0" class="reference"><a href="#cite_note-Dispenzieri-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Pathogenesis">Pathogenesis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=3" title="Edit section: Pathogenesis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>While the main features of this <a href="/wiki/Paraneoplastic_syndrome" title="Paraneoplastic syndrome">paraneoplastic disease</a> have been described, the exact mechanism behind its development, progression, and manifestations remain elusive. Overproduction of the <a href="/wiki/Myeloma_protein" title="Myeloma protein">myeloma protein</a> and <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">VEGF</a> may underlie some, but are insufficient to explain all, of the multi-organ features of the disease. It is suggested that various other <a href="/wiki/Cytokine" title="Cytokine">cytokines</a> produced by the clonal plasma cells, perhaps working in concert with each other as well as with <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">VEGF</a> and the <a href="/wiki/Myeloma_proteins" class="mw-redirect" title="Myeloma proteins">myeloma proteins</a>, mediate many of the features of POEMS syndrome. The other <a href="/wiki/Cytokine" title="Cytokine">cytokines</a> detected in, and suspected of contributing to, POEMS syndrome include <a href="/wiki/IL1B" class="mw-redirect" title="IL1B">interleukin 1β</a>, <a href="/wiki/Interleukin_6" title="Interleukin 6">interleukin 6</a>, and <a href="/wiki/TNF%CE%B1" class="mw-redirect" title="TNFα">TNFα</a>. Nonetheless, it seems likely that some of these paraneoplastic factors, operating individually, make a major contribution to certain features of the disease. For example, <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">VEGF</a>, given its ability to stimulate <a href="/wiki/Angiogenesis" title="Angiogenesis">blood vessel formation</a>, would seem likely to be the major contributor to the pathologic hyper-vascularization changes seem in many tissues, such as <a href="/wiki/Lymph_node" title="Lymph node">lymph nodes</a>, affected by POEMS syndrome.<sup id="cite_ref-Dispenzieri_10-1" class="reference"><a href="#cite_note-Dispenzieri-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=4" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The diagnosis of POEMS syndrome is based on meeting its two mandatory criteria, meeting at least one of its 3 other major criteria, and meeting at least one of its 6 minor criteria.<sup id="cite_ref-ajh_4-6" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Mandatory_criteria">Mandatory criteria</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=5" title="Edit section: Mandatory criteria"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Polyneuropathy">Polyneuropathy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=6" title="Edit section: Polyneuropathy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Polyneuropathy" title="Polyneuropathy">Polyneuropathy</a></div> <p><a href="/wiki/Subacute" class="mw-redirect" title="Subacute">Subacute</a>, distal, symmetrical <a href="/wiki/Sensorimotor_polyneuropathy" class="mw-redirect" title="Sensorimotor polyneuropathy">sensorimotor neuropathy</a> with <a href="/wiki/Allodynia" title="Allodynia">allodynia</a> and <a href="/wiki/Hyperpathia" title="Hyperpathia">hyperpathia</a> is the most frequent presentation of POEMS syndrome. <a href="/wiki/Peripheral_neuropathy" title="Peripheral neuropathy">Neuropathy</a> is often the first trait, and it may be the only initial symptom. Clinical examination may show <a href="/wiki/Wasting" title="Wasting">distal wasting</a>, <a href="/wiki/Weakness" title="Weakness">weakness</a>, and sensory impairment affecting both large and small <a href="/wiki/Stimulus_modality" title="Stimulus modality">fibre sensory modalities</a>.<sup id="cite_ref-clinicalupdate_11-0" class="reference"><a href="#cite_note-clinicalupdate-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Plasma_cell_dyscrasia">Plasma cell dyscrasia</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=7" title="Edit section: Plasma cell dyscrasia"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Plasma_cell_dyscrasias" title="Plasma cell dyscrasias">Plasma cell dyscrasias</a></div> <p><a href="/wiki/Plasma_cell_dyscrasias" title="Plasma cell dyscrasias">Plasma cell dyscrasias</a> are a group of <a href="/wiki/Monoclonal_gammopathy" title="Monoclonal gammopathy">monoclonal gammopathies</a> in which normal <a href="/wiki/Plasma_cell" title="Plasma cell">plasma cells</a> in the <a href="/wiki/Bone_marrow" title="Bone marrow">bone marrow</a> and <a href="/wiki/Soft_tissue" title="Soft tissue">soft tissues</a> become altered. POEMS syndrome is often associated with an <a href="/wiki/Immunoglobulin_A" title="Immunoglobulin A">IgA</a> or <a href="/wiki/Immunoglobulin_G" title="Immunoglobulin G">IgG</a> lambda limited <a href="/wiki/Plasma_cell" title="Plasma cell">plasma cell</a> dysfunction. On <a href="/wiki/Iliac_crest" title="Iliac crest">iliac crest</a> <a href="/wiki/Biopsy" title="Biopsy">biopsies</a>, patients with POEMS syndrome often have few <a href="/wiki/Monoclonal_antibody" title="Monoclonal antibody">monoclonal plasma cells</a>. In patients with localized illness, <a href="/wiki/Iliac_crest" title="Iliac crest">iliac crest</a> <a href="/wiki/Biopsy" title="Biopsy">biopsies</a> may be normal. Other common findings were <a href="/wiki/Megakaryocyte" title="Megakaryocyte">megakaryocyte</a> <a href="/wiki/Hyperplasia" title="Hyperplasia">hyperplasia</a> and clustering, as well as unusual <a href="/wiki/Megakaryocyte" title="Megakaryocyte">megakaryocyte</a> appearances. Atypical <a href="/wiki/Plasma_cell" title="Plasma cell">plasma cells</a> invade normal marrow in <a href="/wiki/Osteosclerosis" title="Osteosclerosis">osteosclerotic</a> <a href="/wiki/Lesion" title="Lesion">lesions</a>, causing <a href="/wiki/Sclerosis_(medicine)" title="Sclerosis (medicine)">sclerosis</a> of the <a href="/wiki/Lamella_(cell_biology)" title="Lamella (cell biology)">bony lamellae</a>.<sup id="cite_ref-clinicalupdate_11-1" class="reference"><a href="#cite_note-clinicalupdate-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Major_criteria">Major criteria</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=8" title="Edit section: Major criteria"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Castleman's_disease"><span id="Castleman.27s_disease"></span>Castleman's disease</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=9" title="Edit section: Castleman's disease"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Castleman_disease" title="Castleman disease">Castleman disease</a></div> <p><a href="/wiki/Castleman_disease" title="Castleman disease">Castleman's disease</a> (CD) is a rare <a href="/wiki/Homogeneity_and_heterogeneity" title="Homogeneity and heterogeneity">heterogeneous</a> <a href="/wiki/Lymph_node" title="Lymph node">lymph node</a> disorder characterized by elevated <a href="/wiki/Interleukin_6" title="Interleukin 6">interleukin-6</a> levels. <a href="/wiki/Peripheral_neuropathy" title="Peripheral neuropathy">Neuropathy</a> can occur in CD patients with or without POEMS syndrome.<sup id="cite_ref-clinicalupdate_11-2" class="reference"><a href="#cite_note-clinicalupdate-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> CD and POEMS tend to overlap, with roughly 15–24% of POEMS syndrome patients also having CD, with the majority having <a href="/wiki/Hyaline" title="Hyaline">hyaline</a> vascular type.<sup id="cite_ref-mjhid_5-2" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Sclerotic_bone_lesions">Sclerotic bone lesions</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=10" title="Edit section: Sclerotic bone lesions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Osteosclerosis" title="Osteosclerosis">Osteosclerotic</a> <a href="/wiki/Lesion" title="Lesion">lesions</a> have been documented in around 95% of patients. Bone <a href="/wiki/Lesion" title="Lesion">lesions</a> can be <a href="/wiki/Sclerotic_ring" class="mw-redirect" title="Sclerotic ring">sclerotic</a>, <a href="/wiki/Lytic_lesion" class="mw-redirect" title="Lytic lesion">lytic</a> with sclerotic rims, or a mixture of the two with a soup-bubble look. About half of the patients have a single bone lesion, whereas the other half have several lesions. The most prevalent locations for bone lesions are the <a href="/wiki/Pelvis" title="Pelvis">pelvis</a>, <a href="/wiki/Vertebral_column" title="Vertebral column">spine</a>, <a href="/wiki/Rib_cage" title="Rib cage">ribs</a>, and <a href="/wiki/Proximal" class="mw-redirect" title="Proximal">proximal</a> extremities.<sup id="cite_ref-mjhid_5-3" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Vascular_endothelial_growth_factor">Vascular endothelial growth factor</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=11" title="Edit section: Vascular endothelial growth factor"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">Vascular endothelial growth factor</a></div> <p><a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">VEGF</a> levels in <a href="/wiki/Plasma_diagnostics" title="Plasma diagnostics">plasma</a> and <a href="/wiki/Serum_(blood)" title="Serum (blood)">serum</a> are significantly higher in POEMS patients and correlate with illness activity. <a href="/wiki/Osteoblast" title="Osteoblast">Osteoblasts</a>, <a href="/wiki/Bone" title="Bone">bone tissue</a>, <a href="/wiki/Macrophage" title="Macrophage">macrophages</a>, <a href="/wiki/Neoplasm" title="Neoplasm">tumor cells</a>, <a href="/wiki/Plasma_cell" title="Plasma cell">plasma cells</a>, and <a href="/wiki/Megakaryocyte" title="Megakaryocyte">megakaryocytes</a> all express <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">VEGF</a>; both IL1 and IL6 have been proven to increase <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">VEGF</a> synthesis. <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">VEGF</a> normally targets <a href="/wiki/Endothelium" title="Endothelium">endothelial</a> cells and causes an increase in vascular permeability that is both fast and reversible. Increased <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">VEGF</a> could explain several clinical features of POEMS, including <a href="/wiki/Organomegaly" title="Organomegaly">organomegaly</a>, <a href="/wiki/Edema" title="Edema">edema</a>, <a href="/wiki/Skin_condition" title="Skin condition">skin abnormalities</a>, and <a href="/wiki/Peripheral_neuropathy" title="Peripheral neuropathy">neuropathy</a>, as well as increasing <a href="/wiki/Blood_vessel" title="Blood vessel">microvascular</a> permeability of blood vessels with <a href="/wiki/Endoneurial_fluid" class="mw-redirect" title="Endoneurial fluid">endoneurial</a> edema.<sup id="cite_ref-mjhid_5-4" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Minor_criteria">Minor criteria</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=12" title="Edit section: Minor criteria"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Organomegaly">Organomegaly</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=13" title="Edit section: Organomegaly"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Organomegaly" title="Organomegaly">Organomegaly</a></div> <p>POEMS syndrome has been associated with <a href="/wiki/Hepatomegaly" title="Hepatomegaly">hepatomegaly</a>, <a href="/wiki/Splenomegaly" title="Splenomegaly">splenomegaly</a>, and <a href="/wiki/Lymphadenopathy" title="Lymphadenopathy">lymphadenopathy</a> in 50–78% of patients. <a href="/wiki/Organomegaly" title="Organomegaly">Organomegaly</a> is usually minimal, and bulky disease is uncommon.<sup id="cite_ref-mjhid_5-5" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Extravascular_volume_overload">Extravascular volume overload</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=14" title="Edit section: Extravascular volume overload"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Peripheral_edema" title="Peripheral edema">Peripheral edema</a>, <a href="/wiki/Ascites" title="Ascites">Ascites</a>, <a href="/wiki/Pleural_effusion" title="Pleural effusion">Pleural effusion</a>, and <a href="/wiki/Pericardial_effusion" title="Pericardial effusion">Pericardial effusion</a></div> <p>80% of POEMS patients are reported to have extravascular volume overload including, <a href="/wiki/Peripheral_edema" title="Peripheral edema">peripheral edema</a>, <a href="/wiki/Ascites" title="Ascites">ascites</a>, <a href="/wiki/Pleural_effusion" title="Pleural effusion">pleural effusion</a>, and <a href="/wiki/Pericardial_effusion" title="Pericardial effusion">pericardial effusion</a>. <a href="/wiki/Ascites" title="Ascites">Ascites</a> and <a href="/wiki/Peripheral_edema" title="Peripheral edema">peripheral edema</a> are more prevalent than <a href="/wiki/Pleural_effusion" title="Pleural effusion">pleural</a> or <a href="/wiki/Pericardial_effusion" title="Pericardial effusion">pericardial effusions</a>. Extravascular volume overload can cause significant morbidity and corresponds with a lower survival rate.<sup id="cite_ref-mjhid_5-6" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Endocrinopathy">Endocrinopathy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=15" title="Edit section: Endocrinopathy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Endocrine_disease" title="Endocrine disease">Endocrine disease</a>, <a href="/wiki/Endocrinology" title="Endocrinology">Endocrinology</a>, and <a href="/wiki/Endocrine_system" title="Endocrine system">Endocrine system</a></div> <p>Approximately 84% of POEMS syndrome patients have characteristics of several <a href="/wiki/Endocrine_disease" title="Endocrine disease">endocrinopathies</a>. <a href="/wiki/Hypogonadism" title="Hypogonadism">Hypogonadism</a> is the most prevalent <a href="/wiki/Endocrine_disease" title="Endocrine disease">endocrine disorder</a>, followed by <a href="/wiki/Thyroid_disease" title="Thyroid disease">thyroid anomalies</a>, <a href="/wiki/Carbohydrate_metabolism" title="Carbohydrate metabolism">glucose metabolism</a> defects, and <a href="/wiki/Adrenal_insufficiency" title="Adrenal insufficiency">adrenal insufficiency</a>.<sup id="cite_ref-ajh_4-7" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Men frequently experience <a href="/wiki/Erectile_dysfunction" title="Erectile dysfunction">impotence</a> and <a href="/wiki/Gynecomastia" title="Gynecomastia">gynecomastia</a>. <a href="/wiki/Amenorrhea" title="Amenorrhea">Amenorrhea</a> tends to be common in women.<sup id="cite_ref-medscape_6-5" class="reference"><a href="#cite_note-medscape-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> The cause of <a href="/wiki/Endocrine_disease" title="Endocrine disease">endocrinopathy</a> is unknown, however <a href="/wiki/Vascular_endothelial_growth_factor" title="Vascular endothelial growth factor">VEGF</a> may have a role.<sup id="cite_ref-mjhid_5-7" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Skin_changes">Skin changes</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=16" title="Edit section: Skin changes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Skin_condition" title="Skin condition">Skin condition</a></div> <p>About 90–100% of those with POEMS syndrome will experience <a href="/wiki/Skin_condition" title="Skin condition">skin changes</a>. The most common manifestations are <a href="/wiki/Hyperpigmentation" title="Hyperpigmentation">hyperpigmentation</a> and <a href="/wiki/Hemangioma" title="Hemangioma">haemangiomas</a>. Other skin abnormalities include thickening, <a href="/wiki/Hypertrichosis" title="Hypertrichosis">hypertrichosis</a>, acquired facial <a href="/wiki/Lipoatrophy" title="Lipoatrophy">lipoatrophy</a>, and infiltrating <a href="/wiki/Livedo_reticularis" title="Livedo reticularis">livedo reticularis</a> with <a href="/wiki/Necrosis" title="Necrosis">necrosis</a>. POEMS syndrome can also cause Vascular-type skin changes including <a href="/wiki/Acrocyanosis" title="Acrocyanosis">acrocyanosis</a>, <a href="/wiki/Flushing_(physiology)" title="Flushing (physiology)">flushing</a>, <a href="/wiki/Hyperaemia" title="Hyperaemia">hyperaemia</a>, and <a href="/wiki/Raynaud_syndrome" title="Raynaud syndrome">Raynaud's phenomenon</a>. <a href="/wiki/Nail_disease" title="Nail disease">Nail changes</a> consist of <a href="/wiki/Leukonychia" title="Leukonychia">leukonychia</a> and <a href="/wiki/Nail_clubbing" title="Nail clubbing">clubbing</a>.<sup id="cite_ref-clinicalupdate_11-3" class="reference"><a href="#cite_note-clinicalupdate-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Papilledema">Papilledema</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=17" title="Edit section: Papilledema"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Papilledema" title="Papilledema">Papilledema</a></div> <p><a href="/wiki/Papilledema" title="Papilledema">Papilledema</a> is often one of the earliest signs of POEMS disease and is usually bilateral.<sup id="cite_ref-mjhid_5-8" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Patients tend to be <a href="/wiki/Asymptomatic" title="Asymptomatic">asymptomatic</a>, however, they may report <a href="/wiki/Headache" title="Headache">headaches</a>, brief obscurations of vision, <a href="/wiki/Scotoma" title="Scotoma">scotomata</a>, large <a href="/wiki/Blind_spot_(vision)" title="Blind spot (vision)">blind spots</a>, and gradual visual field constriction.<sup id="cite_ref-ashpub_8-1" class="reference"><a href="#cite_note-ashpub-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Papilledema" title="Papilledema">Papilledema</a> has been noted in 29–64% of patients and is associated with an unfavorable prognosis.<sup id="cite_ref-mjhid_5-9" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Hematological_alterations">Hematological alterations</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=18" title="Edit section: Hematological alterations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Thrombocythemia" title="Thrombocythemia">Thrombocythemia</a> and <a href="/wiki/Polycythemia" title="Polycythemia">Polycythemia</a></div> <p>50% of POEMS patients have <a href="/wiki/Thrombocythemia" title="Thrombocythemia">thrombocytosis</a> and <a href="/wiki/Polycythemia" title="Polycythemia">polyglobulia</a> develops in 15% of patients.  Those with <a href="/wiki/Thrombocythemia" title="Thrombocythemia">thrombocytosis</a> and <a href="/wiki/Polycythemia" title="Polycythemia">erythrocytosis</a> are often misdiagnosed with <a href="/wiki/Myeloproliferative_neoplasm" title="Myeloproliferative neoplasm">chronic myeloproliferative disease</a> before POEMS syndrome is identified.<sup id="cite_ref-mjhid_5-10" class="reference"><a href="#cite_note-mjhid-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Laboratory_findings">Laboratory findings</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=19" title="Edit section: Laboratory findings"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In addition to tests corresponding to the above findings, such as <a href="/wiki/Electromyography" title="Electromyography">EMG</a> for neuropathy, <a href="/wiki/CT_scan" title="CT scan">CT scan</a>, <a href="/wiki/Bone_marrow_biopsy" class="mw-redirect" title="Bone marrow biopsy">bone marrow biopsy</a> to detect clonal <a href="/wiki/Plasma_cell" title="Plasma cell">plasma cells</a>, <a href="/wiki/Serum_protein_electrophoresis" title="Serum protein electrophoresis">plasma or serum protein electrophoresis</a> to myeloma proteins, other tests can give abnormal results supporting the diagnosis of POEMS syndrome. These included raised blood levels of <a href="/wiki/VEGF" class="mw-redirect" title="VEGF">VEGF</a>, <a href="/wiki/Thrombocytes" class="mw-redirect" title="Thrombocytes">thrombocytes</a>, and/or <a href="/wiki/Erythrocyte" class="mw-redirect" title="Erythrocyte">erythrocyte</a> parameters.<sup id="cite_ref-pmid28299525_3-8" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Differential_diagnosis">Differential diagnosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=20" title="Edit section: Differential diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Patients diagnosed as having Castleman disease but also exhibiting many of the symptoms and signs of POEMS syndrome but lacking evidence of a <a href="/wiki/Peripheral_neuropathy" title="Peripheral neuropathy">peripheral neuropathy</a> and clonal <a href="/wiki/Plasma_cell" title="Plasma cell">plasma cells</a> should not be diagnosed as having POEMS syndrome. They are better classified as having Castleman disease variant of POEMS syndrome. These patients may exhibit high blood levels of the <a href="/wiki/Interleukin-6" class="mw-redirect" title="Interleukin-6">interleukin-6</a> cytokine and have an inferior overall survival compared to POEMS syndrome patients. Treatment of patients with this POEMS syndrome variant who have evidence of bone lesions and/or myeloma proteins are the same as those for POEMS syndrome patients. In the absence of these features, treatment with <a href="/wiki/Rituximab" title="Rituximab">rituximab</a>, a monoclonal antibody preparation directed against B cells bearing the <a href="/wiki/CD20" title="CD20">CD20</a> antigen, or <a href="/wiki/Siltuximab" title="Siltuximab">siltuximab</a>, a monoclonal antibody preparation directed against interleukin-6, may be justified.<sup id="cite_ref-pmid28299525_3-9" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ajh_4-8" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=21" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As reported by Dispenzieri <i>et al.</i><sup id="cite_ref-ajh_4-9" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Mayo_Clinic" title="Mayo Clinic">Mayo Clinic</a> treatment regimens are tailored to treat the clinical manifestations and prognosis for the rate of progression of the POEMS syndrome in each patient. In rare cases, patients may have minimal or no symptoms at presentation or after successful treatment of their disorder. These patients may be monitored every 2–3 months for symptoms and disease progression. Otherwise, treatment is divided based on the local versus systemic spread of its clonal plasma cells. Patients with one or two plasmacytoma bone lesions and no clonal plasma cells in their bone marrow biopsy specimens are treated by surgical removal or <a href="/wiki/Radiotherapy" class="mw-redirect" title="Radiotherapy">radiotherapy</a> of their tumors. These treatments can relieve many of the syndromes clinical manifestations including neuropathies, have a 10-year overall survival of 70% and a 6-year progression-free survival of 62%. Patients with >2 plasmacytoma bone lesions and/or increases in bone marrow clonal plasma cells are treated with a low-dose or high-dose chemotherapy regimen, i.e. a <a href="/wiki/Corticosteroid" title="Corticosteroid">corticosteroid</a> such as <a href="/wiki/Dexamethasone" title="Dexamethasone">dexamethasone</a> plus an <a href="/wiki/Alkylating_antineoplastic_agent" title="Alkylating antineoplastic agent">alkylating agents</a> such as <a href="/wiki/Melphalan" title="Melphalan">melphalan</a>. Dosage regimens are selected on the basis of patient tolerance. Hematological response rates to the dexamethasone/melphalan regimens have been reported to be in the 80% range with neurological response rates approaching 100%. Patients successfully treated with the high-dose dexamethasone/melphalan regimen have been further treated with <a href="/wiki/Autologous_stem_cell_transplantation" class="mw-redirect" title="Autologous stem cell transplantation">autologous stem cell transplantation</a>. In 59 patients treated with the chemotherapy/transplantation regimen, the Mayo Clinic reported progression-free survival rates of 98%, 94%, and 75% at 1, 2, and 5 years, respectively.<sup id="cite_ref-ajh_4-10" class="reference"><a href="#cite_note-ajh-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Other treatment regimens are being studied. <a href="/wiki/Immunomodulatory_imide_drug" class="mw-redirect" title="Immunomodulatory imide drug">Immunomodulatory imide drugs</a> such as <a href="/wiki/Thalidomide" title="Thalidomide">thalidomide</a> and <a href="/wiki/Lenalidomide" title="Lenalidomide">lenalidomide</a> have been used in combination with <a href="/wiki/Dexamethasone" title="Dexamethasone">dexamethasone</a> to treat POEMS syndrome patients. While the mechanism of action of these immunomodulators are not clear, they do inhibit the production of cytokines suspected of contributing to POEMS syndrome such as <a href="/wiki/VEGF" class="mw-redirect" title="VEGF">VEGF</a>, <a href="/wiki/TNF%CE%B1" class="mw-redirect" title="TNFα">TNFα</a>, and <a href="/wiki/Interleukin_6" title="Interleukin 6">IL-6</a> and stimulate <a href="/wiki/T_cells" class="mw-redirect" title="T cells">T cells</a> and <a href="/wiki/NK_cells" class="mw-redirect" title="NK cells">NK cells</a> to increase their production of <a href="/wiki/Interferon_gamma" title="Interferon gamma">interferon gamma</a> and <a href="/wiki/Interleukin_2" title="Interleukin 2">interleukin 2</a> (see <a href="/wiki/Immunomodulatory_imide_drug#Mechanism_of_action" class="mw-redirect" title="Immunomodulatory imide drug">immunomodulatory imide drug's mechanism of action</a>). A double blind study of 25 POEMS syndrome patients found significantly better results (VEGF reduction, neuromuscular function improvement, quality of life improvement) in patients treated with thalidomide plus dexamethasone compared to patients treated with a thalidomide placebo plus dexamethasone.<sup id="cite_ref-pmid28299525_3-10" class="reference"><a href="#cite_note-pmid28299525-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Since VEGF plays a central role in the symptoms of POEMS syndrome, some have tried <a href="/wiki/Bevacizumab" title="Bevacizumab">bevacizumab</a>, a <a href="/wiki/Monoclonal_antibody" title="Monoclonal antibody">monoclonal antibody</a> directed against VEGF. While some reports were positive, others have reported <a href="/wiki/Capillary_leak_syndrome" title="Capillary leak syndrome">capillary leak syndrome</a> suspected to be the result of overly rapid lowering of VEGF levels. It therefore remains doubtful as to whether this will become part of standard treatment for POEMS syndrome.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=22" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>R. S. Crow, working in <a href="/wiki/Bristol" title="Bristol">Bristol</a>, first described the combination of osteosclerotic myeloma, polyneuropathy and various unusual features (such as pigmentation and clubbing) in two patients aged 54 and 67, in 1956.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=POEMS_syndrome&action=edit&section=23" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-rarediseases-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-rarediseases_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-rarediseases_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-rarediseases_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-rarediseases_1-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://rarediseases.info.nih.gov/diseases/7411/poems-syndrome">"POEMS syndrome — About the Disease — Genetic and Rare Diseases Information Center"</a>. <i>rarediseases.info.nih.gov</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2023-08-14</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=rarediseases.info.nih.gov&rft.atitle=POEMS+syndrome+%E2%80%94+About+the+Disease+%E2%80%94+Genetic+and+Rare+Diseases+Information+Center&rft_id=https%3A%2F%2Frarediseases.info.nih.gov%2Fdiseases%2F7411%2Fpoems-syndrome&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-pmid21035860-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-pmid21035860_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-pmid21035860_2-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKaushikPulidoAbreuAmselem2011" class="citation journal cs1">Kaushik M, Pulido JS, Abreu R, Amselem L, Dispenzieri A (2011). "Ocular findings in patients with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome". <i>Ophthalmology</i>. <b>118</b> (4): 778–82. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ophtha.2010.08.013">10.1016/j.ophtha.2010.08.013</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21035860">21035860</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Ophthalmology&rft.atitle=Ocular+findings+in+patients+with+polyneuropathy%2C+organomegaly%2C+endocrinopathy%2C+monoclonal+gammopathy%2C+and+skin+changes+syndrome&rft.volume=118&rft.issue=4&rft.pages=778-82&rft.date=2011&rft_id=info%3Adoi%2F10.1016%2Fj.ophtha.2010.08.013&rft_id=info%3Apmid%2F21035860&rft.aulast=Kaushik&rft.aufirst=M&rft.au=Pulido%2C+JS&rft.au=Abreu%2C+R&rft.au=Amselem%2C+L&rft.au=Dispenzieri%2C+A&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-pmid28299525-3"><span class="mw-cite-backlink">^ <a href="#cite_ref-pmid28299525_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-pmid28299525_3-10"><sup><i><b>k</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWarsameYanamandraKapoor2017" class="citation journal cs1">Warsame R, Yanamandra U, Kapoor P (2017). "POEMS Syndrome: an Enigma". <i>Current Hematologic Malignancy Reports</i>. <b>12</b> (2): 85–95. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs11899-017-0367-0">10.1007/s11899-017-0367-0</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28299525">28299525</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:31324035">31324035</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Current+Hematologic+Malignancy+Reports&rft.atitle=POEMS+Syndrome%3A+an+Enigma&rft.volume=12&rft.issue=2&rft.pages=85-95&rft.date=2017&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A31324035%23id-name%3DS2CID&rft_id=info%3Apmid%2F28299525&rft_id=info%3Adoi%2F10.1007%2Fs11899-017-0367-0&rft.aulast=Warsame&rft.aufirst=R&rft.au=Yanamandra%2C+U&rft.au=Kapoor%2C+P&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-ajh-4"><span class="mw-cite-backlink">^ <a href="#cite_ref-ajh_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-ajh_4-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-ajh_4-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-ajh_4-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-ajh_4-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-ajh_4-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-ajh_4-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-ajh_4-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-ajh_4-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-ajh_4-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-ajh_4-10"><sup><i><b>k</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDispenzieri2019" class="citation journal cs1">Dispenzieri, Angela (23 May 2019). <a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajh.25495">"POEMS Syndrome: 2019 Update on diagnosis, risk-stratification, and management"</a>. <i>American Journal of Hematology</i>. <b>94</b> (7): 812–827. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Fajh.25495">10.1002/ajh.25495</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0361-8609">0361-8609</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31012139">31012139</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:128361561">128361561</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=American+Journal+of+Hematology&rft.atitle=POEMS+Syndrome%3A+2019+Update+on+diagnosis%2C+risk-stratification%2C+and+management&rft.volume=94&rft.issue=7&rft.pages=812-827&rft.date=2019-05-23&rft.issn=0361-8609&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A128361561%23id-name%3DS2CID&rft_id=info%3Apmid%2F31012139&rft_id=info%3Adoi%2F10.1002%2Fajh.25495&rft.aulast=Dispenzieri&rft.aufirst=Angela&rft_id=https%3A%2F%2Fdoi.org%2F10.1002%252Fajh.25495&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-mjhid-5"><span class="mw-cite-backlink">^ <a href="#cite_ref-mjhid_5-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-mjhid_5-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-mjhid_5-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-mjhid_5-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-mjhid_5-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-mjhid_5-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-mjhid_5-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-mjhid_5-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-mjhid_5-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-mjhid_5-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-mjhid_5-10"><sup><i><b>k</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNozza2017" class="citation journal cs1">Nozza, Andrea (1 September 2017). <a rel="nofollow" class="external text" href="https://www.mjhid.org/">"Poems Syndrome: An Update"</a>. <i>Mediterranean Journal of Hematology and Infectious Diseases</i>. <b>9</b> (1): e2017051. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.4084%2Fmjhid.2017.051">10.4084/mjhid.2017.051</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/2035-3006">2035-3006</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584767">5584767</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28894560">28894560</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Mediterranean+Journal+of+Hematology+and+Infectious+Diseases&rft.atitle=Poems+Syndrome%3A+An+Update&rft.volume=9&rft.issue=1&rft.pages=e2017051&rft.date=2017-09-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5584767%23id-name%3DPMC&rft.issn=2035-3006&rft_id=info%3Apmid%2F28894560&rft_id=info%3Adoi%2F10.4084%2Fmjhid.2017.051&rft.aulast=Nozza&rft.aufirst=Andrea&rft_id=https%3A%2F%2Fwww.mjhid.org%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-medscape-6"><span class="mw-cite-backlink">^ <a href="#cite_ref-medscape_6-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-medscape_6-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-medscape_6-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-medscape_6-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-medscape_6-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-medscape_6-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/1097031-overview">"POEMS Syndrome: Background, Pathophysiology, Etiology"</a>. 16 October 2021.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=POEMS+Syndrome%3A+Background%2C+Pathophysiology%2C+Etiology&rft.date=2021-10-16&rft_id=https%3A%2F%2Femedicine.medscape.com%2Farticle%2F1097031-overview&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-nord-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-nord_7-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://rarediseases.org/rare-diseases/poems-syndrome/">"POEMS Syndrome — Symptoms, Causes, Treatment — NORD"</a>. <i>rarediseases.org</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2023-08-16</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=rarediseases.org&rft.atitle=POEMS+Syndrome+%E2%80%94+Symptoms%2C+Causes%2C+Treatment+%E2%80%94+NORD&rft_id=https%3A%2F%2Frarediseases.org%2Frare-diseases%2Fpoems-syndrome%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-ashpub-8"><span class="mw-cite-backlink">^ <a href="#cite_ref-ashpub_8-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-ashpub_8-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDispenzieri2005" class="citation journal cs1">Dispenzieri, Angela (1 January 2005). <a rel="nofollow" class="external text" href="https://ashpublications.org/hematology/article/2005/1/360/19304/POEMS-Syndrome">"POEMS Syndrome"</a>. <i>Hematology Am Soc Hematol Educ Program</i>. <b>2005</b> (1). ash publications: 360–357. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1182%2Fasheducation-2005.1.360">10.1182/asheducation-2005.1.360</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1520-4391">1520-4391</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16304404">16304404</a><span class="reference-accessdate">. Retrieved <span class="nowrap">15 August</span> 2023</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Hematology+Am+Soc+Hematol+Educ+Program&rft.atitle=POEMS+Syndrome&rft.volume=2005&rft.issue=1&rft.pages=360-357&rft.date=2005-01-01&rft.issn=1520-4391&rft_id=info%3Apmid%2F16304404&rft_id=info%3Adoi%2F10.1182%2Fasheducation-2005.1.360&rft.aulast=Dispenzieri&rft.aufirst=Angela&rft_id=https%3A%2F%2Fashpublications.org%2Fhematology%2Farticle%2F2005%2F1%2F360%2F19304%2FPOEMS-Syndrome&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-pmid27866585-9"><span class="mw-cite-backlink">^ <a href="#cite_ref-pmid27866585_9-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-pmid27866585_9-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCastillo2016" class="citation journal cs1">Castillo JJ (2016). "Plasma Cell Disorders". <i>Primary Care</i>. <b>43</b> (4): 677–691. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.pop.2016.07.002">10.1016/j.pop.2016.07.002</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27866585">27866585</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Primary+Care&rft.atitle=Plasma+Cell+Disorders&rft.volume=43&rft.issue=4&rft.pages=677-691&rft.date=2016&rft_id=info%3Adoi%2F10.1016%2Fj.pop.2016.07.002&rft_id=info%3Apmid%2F27866585&rft.aulast=Castillo&rft.aufirst=JJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-Dispenzieri-10"><span class="mw-cite-backlink">^ <a href="#cite_ref-Dispenzieri_10-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Dispenzieri_10-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDispenzieriKyleLacy2003" class="citation journal cs1">Dispenzieri A, Kyle RA, Lacy MQ, et al. (2003). <a rel="nofollow" class="external text" href="https://doi.org/10.1182%2Fblood-2002-07-2299">"POEMS syndrome: definitions and long-term outcome"</a>. <i>Blood</i>. <b>101</b> (7): 2496–506. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1182%2Fblood-2002-07-2299">10.1182/blood-2002-07-2299</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12456500">12456500</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Blood&rft.atitle=POEMS+syndrome%3A+definitions+and+long-term+outcome&rft.volume=101&rft.issue=7&rft.pages=2496-506&rft.date=2003&rft_id=info%3Adoi%2F10.1182%2Fblood-2002-07-2299&rft_id=info%3Apmid%2F12456500&rft.aulast=Dispenzieri&rft.aufirst=A&rft.au=Kyle%2C+RA&rft.au=Lacy%2C+MQ&rft_id=https%3A%2F%2Fdoi.org%2F10.1182%252Fblood-2002-07-2299&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-clinicalupdate-11"><span class="mw-cite-backlink">^ <a href="#cite_ref-clinicalupdate_11-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-clinicalupdate_11-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-clinicalupdate_11-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-clinicalupdate_11-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBrownGinsberg2019" class="citation journal cs1">Brown, Rachel; Ginsberg, Lionel (1 January 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342878">"POEMS syndrome: clinical update"</a>. <i>Journal of Neurology</i>. <b>266</b> (1): 268–277. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs00415-018-9110-6">10.1007/s00415-018-9110-6</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342878">6342878</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30498913">30498913</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Neurology&rft.atitle=POEMS+syndrome%3A+clinical+update&rft.volume=266&rft.issue=1&rft.pages=268-277&rft.date=2019-01-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6342878%23id-name%3DPMC&rft_id=info%3Apmid%2F30498913&rft_id=info%3Adoi%2F10.1007%2Fs00415-018-9110-6&rft.aulast=Brown&rft.aufirst=Rachel&rft.au=Ginsberg%2C+Lionel&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6342878&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSamarasBauerStenner-Liewen2007" class="citation journal cs1">Samaras P, Bauer S, Stenner-Liewen F, et al. (2007). <a rel="nofollow" class="external text" href="http://www.haematologica.org/cgi/content/full/92/10/1438">"Treatment of POEMS syndrome with bevacizumab"</a>. <i>Haematologica</i>. <b>92</b> (10): 1438–9. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.3324%2Fhaematol.11315">10.3324/haematol.11315</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18024383">18024383</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Haematologica&rft.atitle=Treatment+of+POEMS+syndrome+with+bevacizumab&rft.volume=92&rft.issue=10&rft.pages=1438-9&rft.date=2007&rft_id=info%3Adoi%2F10.3324%2Fhaematol.11315&rft_id=info%3Apmid%2F18024383&rft.aulast=Samaras&rft.aufirst=P&rft.au=Bauer%2C+S&rft.au=Stenner-Liewen%2C+F&rft_id=http%3A%2F%2Fwww.haematologica.org%2Fcgi%2Fcontent%2Ffull%2F92%2F10%2F1438&rfr_id=info%3Asid%2Fen.wikipedia.org%3APOEMS+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-13">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCrow_RS1956" class="citation journal cs1">Crow RS (1956). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2035359">"Peripheral neuritis in myelomatosis"</a>. <i>Br Med J</i>. <b>2</b> (4996): 802–4. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmj.2.4996.802">10.1136/bmj.2.4996.802</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2035359">2035359</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/13364332">13364332</a>.</cite><span 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li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q2553422" class="extiw" title="d:Q2553422">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1219149360%2Fother">2A83.Y</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/D47.7">D47.7</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=273.8">273.8</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D016878">D016878</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb29226.htm">29226</a></li><li><b><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a></b>: <a rel="nofollow" class="external text" href="http://snomed.info/id/79268002">79268002</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/derm/771-overview">derm/771</a></li><li><b><a href="/wiki/GARD" class="mw-redirect" title="GARD">GARD</a></b>: <a rel="nofollow" class="external text" href="https://rarediseases.info.nih.gov/diseases/7411/POEMS-syndrome">POEMS syndrome</a></li><li><b><a href="/wiki/Orphanet" title="Orphanet">Orphanet</a></b>: <a rel="nofollow" class="external text" href="https://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=en&Expert=2905">2905</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" 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title="Plasmacytoma">Plasmacytoma</a></li> <li><a href="/wiki/Multiple_myeloma" title="Multiple myeloma">Multiple myeloma</a> (<a href="/wiki/Plasma_cell_leukemia" title="Plasma cell leukemia">Plasma cell leukemia</a>)</li> <li><a href="/wiki/Monoclonal_gammopathy_of_undetermined_significance" title="Monoclonal gammopathy of undetermined significance">MGUS</a></li> <li><i><a href="/wiki/Immunoglobulin_M" title="Immunoglobulin M">IgM</a></i> (<a href="/wiki/Macroglobulinemia" title="Macroglobulinemia">Macroglobulinemia</a>/<a href="/wiki/Waldenstr%C3%B6m_macroglobulinemia" title="Waldenström macroglobulinemia">Waldenström macroglobulinemia</a>)</li> <li><i><a href="/wiki/Immunoglobulin_heavy_chain" title="Immunoglobulin heavy chain">heavy chain</a></i> (<a href="/wiki/Heavy_chain_disease" title="Heavy chain disease">Heavy chain disease</a>)</li> <li><i><a href="/wiki/Immunoglobulin_light_chain" title="Immunoglobulin light chain">light chain</a></i> (<a href="/wiki/AL_amyloidosis" title="AL amyloidosis">Primary amyloidosis</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other <a href="/wiki/Hypergammaglobulinemia" title="Hypergammaglobulinemia">hypergammaglobulinemia</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cryoglobulinemia" title="Cryoglobulinemia">Cryoglobulinemia</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Congenital_abnormality_syndromes" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Congenital_abnormality_syndromes" title="Template:Congenital abnormality syndromes"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Congenital_abnormality_syndromes" title="Template talk:Congenital abnormality syndromes"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Congenital_abnormality_syndromes" title="Special:EditPage/Template:Congenital abnormality syndromes"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Congenital_abnormality_syndromes" style="font-size:114%;margin:0 4em"><a href="/wiki/Congenital_abnormality" class="mw-redirect" title="Congenital abnormality">Congenital abnormality</a> syndromes</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Craniofacial_abnormality" title="Craniofacial abnormality">Craniofacial</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acrocephalosyndactyly" title="Acrocephalosyndactyly">Acrocephalosyndactyly</a> <ul><li><a href="/wiki/Apert_syndrome" title="Apert syndrome">Apert syndrome</a></li> <li><a href="/wiki/Carpenter_syndrome" title="Carpenter syndrome">Carpenter syndrome</a></li> <li><a href="/wiki/Pfeiffer_syndrome" title="Pfeiffer syndrome">Pfeiffer syndrome</a></li> <li><a href="/wiki/Saethre%E2%80%93Chotzen_syndrome" title="Saethre–Chotzen syndrome">Saethre–Chotzen syndrome</a></li> <li><a href="/wiki/Sakati%E2%80%93Nyhan%E2%80%93Tisdale_syndrome" title="Sakati–Nyhan–Tisdale syndrome">Sakati–Nyhan–Tisdale syndrome</a></li> <li><a href="/wiki/Bonnet%E2%80%93Dechaume%E2%80%93Blanc_syndrome" title="Bonnet–Dechaume–Blanc syndrome">Bonnet–Dechaume–Blanc syndrome</a></li></ul></li> <li>Other <ul><li><a href="/wiki/Baller%E2%80%93Gerold_syndrome" title="Baller–Gerold syndrome">Baller–Gerold syndrome</a></li> <li><a href="/wiki/Cyclopia" title="Cyclopia">Cyclopia</a></li> <li><a href="/wiki/Goldenhar_syndrome" title="Goldenhar syndrome">Goldenhar syndrome</a></li> <li><a href="/wiki/Moebius_syndrome" title="Moebius syndrome">Moebius syndrome</a></li> <li><a href="/wiki/Pierre_Robin_sequence" title="Pierre Robin sequence">Pierre Robin sequence</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Short_stature" title="Short stature">Short stature</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/1q21.1_deletion_syndrome" title="1q21.1 deletion syndrome">1q21.1 deletion syndrome</a></li> <li><a href="/wiki/Aarskog%E2%80%93Scott_syndrome" title="Aarskog–Scott syndrome">Aarskog–Scott syndrome</a></li> <li><a href="/wiki/Cockayne_syndrome" title="Cockayne syndrome">Cockayne syndrome</a></li> <li><a href="/wiki/Cornelia_de_Lange_syndrome" title="Cornelia de Lange syndrome">Cornelia de Lange syndrome</a></li> <li><a href="/wiki/Dubowitz_syndrome" title="Dubowitz syndrome">Dubowitz syndrome</a></li> <li><a href="/wiki/Noonan_syndrome" title="Noonan syndrome">Noonan syndrome</a></li> <li><a href="/wiki/Robinow_syndrome" title="Robinow syndrome">Robinow syndrome</a></li> <li><a href="/wiki/Silver%E2%80%93Russell_syndrome" title="Silver–Russell syndrome">Silver–Russell syndrome</a></li> <li><a href="/wiki/Seckel_syndrome" title="Seckel syndrome">Seckel syndrome</a></li> <li><a href="/wiki/Smith%E2%80%93Lemli%E2%80%93Opitz_syndrome" title="Smith–Lemli–Opitz syndrome">Smith–Lemli–Opitz syndrome</a></li> <li><a href="/wiki/Snyder%E2%80%93Robinson_syndrome" title="Snyder–Robinson syndrome">Snyder–Robinson syndrome</a></li> <li><a href="/wiki/Turner_syndrome" title="Turner syndrome">Turner syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Congenital_limb_deformities" title="Congenital limb deformities">Limbs</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adducted_thumb_syndrome" title="Adducted thumb syndrome">Adducted thumb syndrome</a></li> <li><a href="/wiki/Holt%E2%80%93Oram_syndrome" title="Holt–Oram syndrome">Holt–Oram syndrome</a></li> <li><a href="/wiki/Klippel%E2%80%93Tr%C3%A9naunay_syndrome" title="Klippel–Trénaunay syndrome">Klippel–Trénaunay syndrome</a></li> <li><a href="/wiki/Nail%E2%80%93patella_syndrome" title="Nail–patella syndrome">Nail–patella syndrome</a></li> <li><a href="/wiki/Rubinstein%E2%80%93Taybi_syndrome" title="Rubinstein–Taybi syndrome">Rubinstein–Taybi syndrome</a></li> <li><a href="/wiki/Gastrulation" title="Gastrulation">Gastrulation</a>/<a href="/wiki/Mesoderm" title="Mesoderm">mesoderm</a>: <ul><li><a href="/wiki/Caudal_regression_syndrome" title="Caudal regression syndrome">Caudal regression syndrome</a></li> <li><a href="/wiki/Ectromelia" title="Ectromelia">Ectromelia</a></li> <li><a href="/wiki/Sirenomelia" title="Sirenomelia">Sirenomelia</a></li> <li><a href="/wiki/VACTERL_association" title="VACTERL association">VACTERL association</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Overgrowth_syndrome" title="Overgrowth syndrome">Overgrowth syndromes</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bannayan%E2%80%93Riley%E2%80%93Ruvalcaba_syndrome" title="Bannayan–Riley–Ruvalcaba syndrome">Bannayan–Riley–Ruvalcaba syndrome</a></li> <li><a href="/wiki/Beckwith%E2%80%93Wiedemann_syndrome" title="Beckwith–Wiedemann syndrome">Beckwith–Wiedemann syndrome</a></li> <li><a href="/wiki/Benign_symmetric_lipomatosis" title="Benign symmetric lipomatosis">Benign symmetric lipomatosis</a></li> <li><a href="/wiki/Klippel%E2%80%93Tr%C3%A9naunay_syndrome" title="Klippel–Trénaunay syndrome">Klippel–Trénaunay syndrome</a></li> <li><a href="/wiki/Neurofibromatosis_type_I" title="Neurofibromatosis type I">Neurofibromatosis type I</a></li> <li><a href="/wiki/Perlman_syndrome" title="Perlman syndrome">Perlman syndrome</a></li> <li><a href="/wiki/Proteus_syndrome" title="Proteus syndrome">Proteus syndrome</a></li> <li><a href="/wiki/Sotos_syndrome" title="Sotos syndrome">Sotos syndrome</a></li> <li><a href="/wiki/Tatton-Brown%E2%80%93Rahman_syndrome" title="Tatton-Brown–Rahman syndrome">Tatton-Brown–Rahman syndrome</a></li> <li><a href="/wiki/Weaver_syndrome" title="Weaver syndrome">Weaver syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Laurence–Moon–Bardet–Biedl</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bardet%E2%80%93Biedl_syndrome" title="Bardet–Biedl syndrome">Bardet–Biedl syndrome</a></li> <li><a href="/wiki/Laurence%E2%80%93Moon_syndrome" title="Laurence–Moon syndrome">Laurence–Moon syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Combined/other,<br />known locus</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Chromosome_2_(human)" class="mw-redirect" title="Chromosome 2 (human)">2</a></i> (<a href="/wiki/Feingold_syndrome" title="Feingold syndrome">Feingold syndrome</a>)</li> <li><i><a href="/wiki/Chromosome_3_(human)" class="mw-redirect" title="Chromosome 3 (human)">3</a></i> (<a href="/wiki/Zimmermann%E2%80%93Laband_syndrome" title="Zimmermann–Laband syndrome">Zimmermann–Laband syndrome</a>)</li> <li><i><a href="/wiki/Chromosome_4_(human)" class="mw-redirect" title="Chromosome 4 (human)">4</a>/<a href="/wiki/Chromosome_13_(human)" class="mw-redirect" title="Chromosome 13 (human)">13</a></i> (<a href="/wiki/Fraser_syndrome" title="Fraser syndrome">Fraser syndrome</a>)</li> <li><i><a href="/wiki/Chromosome_8_(human)" class="mw-redirect" title="Chromosome 8 (human)">8</a></i> (<a href="/wiki/Branchio-oto-renal_syndrome" title="Branchio-oto-renal syndrome">Branchio-oto-renal syndrome</a>, <a href="/wiki/CHARGE_syndrome" title="CHARGE syndrome">CHARGE syndrome</a>)</li> <li><i><a href="/wiki/Chromosome_12_(human)" class="mw-redirect" title="Chromosome 12 (human)">12</a></i> (<a href="/wiki/Keutel_syndrome" title="Keutel syndrome">Keutel syndrome</a>, <a href="/wiki/Timothy_syndrome" title="Timothy syndrome">Timothy syndrome</a>)</li> <li><i><a href="/wiki/Chromosome_15_(human)" class="mw-redirect" title="Chromosome 15 (human)">15</a></i> (<a href="/wiki/Marfan_syndrome" title="Marfan syndrome">Marfan syndrome</a>)</li> <li><i><a href="/wiki/Chromosome_19_(human)" class="mw-redirect" title="Chromosome 19 (human)">19</a></i> (<a href="/wiki/Donohue_syndrome" title="Donohue syndrome">Donohue syndrome</a>)</li> <li>Multiple <ul><li><a href="/wiki/Fryns_syndrome" title="Fryns syndrome">Fryns syndrome</a></li></ul></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1&useformat=desktop" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=POEMS_syndrome&oldid=1246876993">https://en.wikipedia.org/w/index.php?title=POEMS_syndrome&oldid=1246876993</a>"</div></div> <div id="catlinks" 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