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Polyneuropathy in POEMS Syndrome

https://doi.org/10.30629/2658-7947-2020-25-4-38-44

Abstract

A rare version of paraproteinemic hemablastosis, with the onset characterized by Peripheral Nerve Disease, is POEMS- syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin Changes). In the foreground of the clinical picture of this oncohematological disease is progressive sensorimotor polyneuropathy, which is the reason for the primary reference to a neurologist long before the provision of specialized hematological care. The article provides an overview of recent scientific publications devoted to this disease. Its pathogenetic mechanisms are discussed, as well as the basis of endothelial growth factor. The authors present their own clinical observation of a 62-year-old patient. The onset of the disease was characterized by polyneuropathy accompanied by changes in the M-protein index, organomegaly in the absence of bone-destructive changes, which made the diagnosis difficult. Additional clinical signs included fever, edema (ascites, exudative pleurisy), and hypoproteinemia, changes in peripheral blood (moderate leukocytosis with a decrease in the level of erythrocytes and platelets, which is atypical), kidney and cardiovascular damage. Despite the specific therapy, the patient’s condition was complicated by the development of infectious complications and was fatal. This clinical observation illustrates the need for a careful differential search for a possible cause of non-polyneuropathy of unknown genesis.

About the Authors

E. S. Shishkina
Kirov State Medical University
Russian Federation
Kirov


M. V. Muhacheva
Kirov Regional Clinical Hospital
Russian Federation
Kirov


T. V. Baidina
Perm State Medical University
Russian Federation
Perm


References

1. Ponomarev V.V. Redkie nevrologicheskie sindromy i bolezni. SPb., 2005. (in Russian).

2. Kholodova N.B., Sotnikov V.M., Dobrovolskaya N.Yu., Ponkratova Yu.A. Clinical characteristics and treatment of polyneuropathy developed after chemotherapy. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2013;5:20–24. (in Russian). https://www.mediasphera.ru/issues/zhurnal-nevrologii-i-psikhiatrii-im-s-s-korsakova/2013/5/031997-7298201354

3. Stamo A.P., Grigorieva V.N. Clinical characteristics of pain syndrome in patients with multiple myeloma. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2016;10:11–15. (in Russian). https://doi.org/10.17116/jnevro201611610111-15

4. Yakovlev A.A., Yakovleva M.V. Clinical features of peripheral neuropathy in paraproteinemic hemoblastosis. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2014;10:5–8. (in Russian). https://www.mediasphera.ru/issues/zhurnal-nevrologii-i-psikhiatrii-im-s-s-korsakova/2014/10/031997-72982014101

5. Shishkina E.S., Bajdina T.V., Fokina E.S., Minaeva N.V. Somatic and autonomic neuropathy at oncohematological diseases. Medicinskij al’manah. 2018;5(56):112–116. (in Russian). https://doi.org/10.21145/2499-9954-2018-5-112-116

6. Crow R.S. Peripheral neuritis in myelomatosis. Br. Med. J. 1956;2:805–804. https://doi.org/10.1136/bmj.2.4996.802

7. Shimpo S. Solitary myeloma causing polyneuritis and endocrine disorders. Nippon. Rinsho. 1968;10:2444–56.

8. Takatsuki K., Yodoi J., Wakisaka K., Yoshimi T., Komatsu Y. Plasma cell dyscrasia with polyneuritis and endocrine anomaly: endocrinological study of a new syndrome. Nippon. Rinsho. 1974;50:567.

9. Nakanishi T., Sobue I., Toyokura Y., Nishitani H., Kuroiwa Y., Satoyoshi E. et al. The Crow-Fukase syndrome: a study of 102 cases in Japan. Neurology 1984;34:712–20. https://doi.org/10.1212/wnl.34.6.712

10. Bardwick P.A., Zvaifler N.J., Gill G.N., Newman D., Greenway G.D., Resnick D.L. Plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes: the POEMS syndrome. Report on two cases and a review of the literature. Medicine (Baltimore). 1980;59:311–22. https://doi.org/10.1097/00005792-198007000-00006

11. Gordeev A.V., Mutovina Z.Yu. Japanese systemic disease (POEMS syndrome). Terapevticheskii arkhiv. 2006;12:7–9. (in Russian).

12. Piradov M.A., Suponeva N.A., Ginzberg M.A., Nikitin S.S., Varlamova E.U., Ryzhko V.V. et al. POEMS-syndrome: a literature review and case reports. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2014;4:4–10. (in Russian). https://www.mediasphera.ru/issues/zhurnal-nevrologii-i-psikhiatrii-im-s-s-korsakova/2014/4/031997-7298201441

13. Klodzinskij A.A., Ryzhko V.V., Sorkina O.M., Kaplanskaja I.B., Semyonova E.A., Varlamova E.J. et al. POEMS syndrome (a case report and literature review). Klinicheskaya onkogematologiya. 2008;1(2):52–58. (in Russian).

14. Grigoryeva V.N., Stamo A.P., Avdonina Yu.D., Belyakov K.M. The pattern of peripheral nervous system deterioration in multiple myeloma Nevrologicheskij zhurnal. 2013;2:4–10. (in Russian). https://www.elibrary.ru/download/elibrary_19040752_44303109.pdf

15. Barlamov P.N., Golubeva M.E., Vasilieva E.R., Meres S.V., Shchekotov V.V. Case of the late diagnosis of poems-syndrome. Klinicist. 2011;4:48 52. (in Russian). https://doi.org/10.17650/1818-8338-2011-4-48-52

16. Nasu S., Misawa S., Sekiguchi Y., Shibuya K., Kanai K., Fujimaki Y. et al. Different neurological and physiological profiles in POEMS syndrome and chronic inflammatory demyelinating polyneuropathy. J. Neurol. Neurosurg. Psychiatry. 2012;83:476–479. http://doi.org/10.1136/jnnp-2011-301706

17. Isose S., Misawa S., Kanai K., Shibuya K., Sekiguchi Y., Nasu S. et al. POEMS syndrome with Guillan-Barre syndrome-like acute onset: a case report and review of neurological progression in 30 cases. J. Neurol. Neurosurg. Psychiatry. 2011;82(6):678–680. https://doi.org/10.1136/jnnp.2010.205369

18. Sojka M., Gajos A., Pigonska J., Bogucki M., Tyfa K., Bogucki A. Guillan-Barre syndrome as the first manifestation of POEMS syndrome. Neurol. Neurochir. Pol. 2012;46(3):284–287. https://doi.org/10.5114/ninp.2012.29136

19. Casper C. The aetiology and management of Castleman disease at 50 years: translating pathophysiology to patient care. Br. J. Haematol. 2005;129(1):3–17. https://doi.org/10.1111/j.1365-2141.2004.05311.x

20. Dispenzieri A. POEMS syndrome. Hematology. 2005;1:360–367. https://doi.org/10.1182/asheducation-2005.1.360

21. Adams D., Said G. Ultrastructural characterization of the M protein in nerve biopsy of patients with POEMS syndrome. J. Neurol. Neurosurg. Psychiatr. 1998;64(6):809–12. http://doi.org/10.1136/jnnp.64.6.809

22. Miralles G.D., O’Fallon J.R., Talley N.J. Plasma-cell dyscrasia with polyneuropathy. The spectrum of POEMS syndrome. N. Eng. J. Med. 1992;327:27:1919–1923. https://doi.org/10.1056/NEJM199212313272705

23. Pagnoux C., Guilliven L. Peripheral neuropathy in systemic vasculitides. Curr Opin Rheumatol. 2005;17:41–48. https://doi.org/10.1097/01.bor.0000145518.91595.2f

24. Bessmel’cev S.S. Multiple myeloma (lecture) Vestnik gematologii. 2014;10(3):6–17. (in Russian). http://www.bloodscience.ru/pdf/verstka_VG14-03_web.pdf

25. Dispenzieri A. POEMS syndrome: 2011 update on diagnosis, risk-stratification, and management. Am. J. Hematology. 2012;87:805–814. https://doi.org/10.1002/ajh.22050

26. Merkulova D.M., Andreeva N.E., Merkulov Y.A., Nikitin S.S., Chernova P.A. Neuropathies associated with gammopathies of undetermined significance. Nevrologicheskiy zhurnal. 2008;2:48–52. (in Russian).

27. Lesprit P., Godeau B., Authier F.J. Soubrier M., Zuber M., Larroche C. et al. Pulmonary hypertension in POEMS syndrome: a new feature mediated by cytokines. Am. J. Respir. Crit. Care Med. 1998;157(3):907–11. https://doi.org/10.1164/ajrccm.157.3.9707095

28. Dispenzieri A., Moreno-Aspitia A., Suarez G.A., Lacy M.Q., Colon-Otero G., Tefferi A. et al. Peripheral blood stem cell transplantation in 16 patients with POEMS syndrome, and a review of the literature. Blood. 2004;104:3400–7. https://doi.org/10.1182/blood-2004-05-2046

29. Goncharova A.Ya., Evtushenko S.K., Simonyan V.A., Sergienko A.V., Evtushenko I.S., Gnilorybov A.M. POEMS syndrome as manifestation of paraneoplastic process in ovarian cancer. Mezhdunarodnyj nevrologicheskij zhurnal. 2012;5(51):143–148 (in Russian). http://www.mif-ua.com/archive/article/34013

30. Strokov I.A., Hazime Yu.M., Kozlovskaya L.V., Milovanova S.Yu., Golovacheva V.A., Ahmedzhanova L.T. Neuropathies in cryoglobulinemia. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2013;113(8):70–75. (in Russian). https://www.mediasphera.ru/issues/zhurnal-nevrologii-i-psikhiatrii-im-s-s-korsakova/2013/8/031997-72982013813

31. Smirnov A.V., Pechetov A.A., Karmazonovskij G.G. Castlemanˈs disease. Onkologiya. Zhurnal im. P.A. Gercena. 2014;3(1):106–106. (in Russian). https://www.mediasphera.ru/issues/onkologiya-zhurnal-im-p-a-gertsena/2014/1/322305-218X20150197

32. Sarrot-Reynauld F. Castlemanˈs disease. Orph. Encycl. 2001:1-4. https://www.orpha.net/data/patho/Pro/en/Castleman-FRenPro3618.pdf

33. Sinisalo M., Hietaharju A., Sauranen J., Wirta O. Thalidomide in POEMS syndrome: case report. Am. J. Hematol. 2004;76:66–8. https://doi.org/10.1002/ajh.20051

34. Glavinskaya N.G., Trayan D.A., Ivanova I.B., Gorshechnikova N.V., Popova V.A., Merkur’ev V.N. POEMS-sindrome. Tihookeanskij medicinskij zhurnal. 2017;3:92–94. (in Russian). https://doi.org/10.17238/PmJ1609-1175.2017.2.92-94


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For citations:


Shishkina E.S., Muhacheva M.V., Baidina T.V. Polyneuropathy in POEMS Syndrome. Russian neurological journal. 2020;25(4):38-44. (In Russ.) https://doi.org/10.30629/2658-7947-2020-25-4-38-44

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