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A 47-year-old female with a prior history of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome was admitted with transient ischemic attacks complicated by dysarthria and right-sided hemiparesis. A blood survey indicated thrombocytosis and hyperfibrinogenemia while imaging of intracranial vasculat...
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Thromboses are prevalent in POEMS syndrome, but few risk factors for POEMS‐associated thrombosis have been identified. The objective of this study is to identify novel risk factors for POEMS‐associated thrombosis. In this retrospective cohort of 230 POEMS patients, 27% developed thrombosis. Arterial events were slightly more common than venous. Str...
Citations
... Several studies have documented the presence of a multi-vessel anomaly. [13][14][15][16], but cerebral vasculopathy's pathogenesis is unclear. In this report, we present the case of a young female diagnosed with POEMS syndrome who experienced acute neurological de cits during her treatment. ...
Symptoms of cognitive and motor impairments are the most important factors when considering children with cerebral infarction and polyneuropathy, organomegaly, endocrinopathy, myeloma protein, and skin changes (POEMS) syndrome.
Purpose
What factors are important between POEMS Syndrome and ischemic stroke? Are there novel diagnostics for reducing stroke incidence in POEMS Syndrome?
Method
An observational study comprised 100 patients without CT or MRI and 340 multilingual participants with CT and MRI. All relevant behavior and demographic information were recorded. Per the familial history of POEMS Syndrome, we selected one teenager with cerebral infarction and visual cognition.
Result
A few studies have used a representative sample of children with cerebral disorders in which all patients were investigated separately. Occasionally, severe motor impairment in children is often suggested but not investigated, while cognitive impairment was evident among this populace. Thus, it is advised and required to conduct long-term neuropsychological studies that consider not just interventional studies but also very young cohorts with severe speech and movement disorders alongside visual cognitive issues as failure in the evaluation may overestimate the prevalence of mental disorder.
Conclusion
The endocrine system's role in neurocognition and neuroplasticity behavior is distinct. Clinical educators must maintain the multifaceted interplay between gender, hormones, dosage, exposure time, and brain structure. These complex implications are moving the field of neuroendocrinology with exciting new concepts.
... However, only a few patients have been reported to have ischemic stroke. The multi-vessel anomaly was documented in several studies [13][14][15][16], but the pathogenesis of cerebral vasculopathy is not clear. ...
... It was noteworthy for moderate anemia (Red blood cell count 3.24×10 12 /L, hemoglobin 85 g/L), thrombocytosis (Platelet count 512×10 9 /L), hyperhomocysteinemia (21.3 umol/L), hypoalbuminemia (35 g/L), hyperuricemia (525 umol/L), hyperfibrinogenemia (5.96 g/L), and increased blood urea nitrogen concentration (12.24 mg/L). Hypersensitive C-reactive protein (Hs-CRP, 15.82 mg/L) was slightly ...
... Besides the manifestations commonly seen in this syndrome, arterial or venous thrombosis is attracting increasing attention as a less-recognized feature which is suggested to be a predictor of poor prognosis [8,10,11,14]. So far, several cases of ischemic stroke in patients with POEMS syndrome have been reported in the literature [8,10,[12][13][14][15]. ...
Background
POEMS syndrome is a rare multi-systemic disease characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. Arterial or venous thrombosis is a less-common complication of POEMS syndrome. Ischemic stroke has also been reported sporadically. However, the association between POEMS syndrome and ischemic stroke has not been entirely understood.
Methods
A case of ischemic stroke caused by cerebral vasculitis in a patient with POEMS syndrome was presented. Then a comprehensive review and analysis of the literature were performed.
Results
A total of 28 patients were identified. The common clinical manifestations of POEMS syndrome were rather non-specific in patients with ischemic stroke compared with those of patients without ischemic stroke. Twenty patients were found with multiple ischemic lesions (71.5%). In the 25 patients who had undergone the evaluation of cerebral arteries, nineteen patients (76.0%) were found with cerebral vasculopathy. Twelve patients (48.0%) had more than one cerebral artery involved. Ischemic events were documented in 8 patients even when they were undergoing all the therapy for ischemic stroke. Ten (55.6%) of the 18 patients who had survival data died within two years after stroke events.
Conclusion
Comprehensive analysis of literature revealed several trends in patients with ischemic stroke and POEMS syndrome including a low survival rate and a preponderance of cerebral vasculopathy and multiple cerebral arteries affected. Ischemic stroke may be a poor outcome predictor in patients with POEMS syndrome. Further researches focusing on a larger cohort may help in better characterizing and treating this rare complication of POEMS syndrome.
POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome is a rare paraneoplastic syndrome elicited by plasma cell dyscrasia. Its clinical manifestations are multiple and stroke is not a recognized feature. A 44-year-old woman with a 3-month history of bilateral lower extremity sensorimotor disturbance was admitted to our hospital. Examinations revealed polyneuropathy, organomegaly, hypothyroidism, monoclonal gammopathy, pelvic plasmacytoma, and elevated serum vascular endothelial growth factor (VEGF) levels. A diagnosis of POEMS was made. Her condition was improved by radiation therapy of her pelvic plasmacytoma and she continued to be seen on an outpatient basis. Five years after her first admission she was re-admitted with sudden-onset right hemiparesis. A brain computed tomography (CT) scan revealed a left intracranial hemorrhage and magnetic resonance (MR) angiography and cerebral angiography showed occlusion of the proximal portion of the bilateral middle cerebral artery and narrowing of the bilateral internal carotid artery at the terminal portion; moyamoya vessels were seen. This is the first report of a patient whose intracranial hemorrhage was attributable to quasi-moyamoya disease associated with POEMS syndrome. We suggest that the POEMS syndrome be ruled out in the differential diagnosis of patients presenting with atypical stroke, multivessel stenotic lesions (moyamoya vessels), and polyneuropathy.
