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POEMS syndromePOEMS syndrome (also known as Crow-Fukase syndrome, Takatsuki disease, or PEP syndrome) is a rare medical syndrome named for its main clinically recognizable features: Polyneuropathy (peripheral nerve damage), Organomegaly (abnormal enlargement of organs), Endocrinopathy (damage to hormone-producing glands)/Edema, M-protein (an abnormal antibody) and Skin abnormalities (including hyperpigmentation and hypertrichosis). Additional recommended knowledge
DiagnosisIt was originally described in part by various investigators, and received its present name in 1980 by Bardwick et al[1]. A 2003 study[2] followed a series of 99 patients and attempted to delineate criteria for the diagnosis of POEMS syndrome. According to their study, two major criteria and one minor criterion are required for the diagnosis:
In addition, their study showed a number of associations, the relevance of which to diagnosis was unclear: clubbing, weight loss, thrombocytosis, polycythemia and hyperhidrosis. Possible associations included pulmonary hypertension, restrictive lung disease, a thrombotic diathesis, arthralgia, cardiomyopathy (systolic dysfunction), fever, low vitamin B12 levels and diarrhea. PathogenesisWhile the main features of the disease have been described, the exact mechanism of the disease has remained elusive. The paraprotein alone is insufficient to explain the multi-organ features, and various cytokines produced by plasmacytoma cells have therefore been linked with the features of POEMS syndrome, specifically interleukin 1β, interleukin 6 and TNFα. There also seems to be a role of vascular endothelial growth factor, given the angiogenetic changes in many tissues.[2] TreatmentDispenzieri et al[2] list numerous treatments, the effect of many of which is almost anecdotal. Prednisolone and alkylating agents are the most commonly used. References
Categories: Endocrinology | Neurological disorders | Rare diseases | Syndromes |
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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "POEMS_syndrome". A list of authors is available in Wikipedia. |