A case of POEMS syndrome associated with reactive amyloidosis and Waldenström's macroglobulinaemia.

Abstract

A72-year-old Japanese man presented with a 5-year history of fatigue, night sweats, oedema of dorsum of foot, muscle weakness, and paresthesia of the lower extremities. On examination, the patient fulfilled the diagnostic criteria for POEMS syndrome, but was unusual in that he also had underling Waldenström's macroglobulinaemia with IgM kappa. The M protein of POEMS syndrome is usually IgG and IgA with lambda light chains. To our knowledge, there are only three cases of POEMS syndrome with IgM kappa including our case. Autopsy findings revealed that small lymphocytes were more prominent than plasma cells in the bone marrow. These plasma cells were stained with IgM kappa. Amyloid deposits identified by Congo red stain were detected predominantly in the vascular walls of the gastrointestinal tract, pancreas and kidney. This amyloid protein was classified as amyloid associated protein. This is the first case of POEMS syndrome associated with reactive amyloidosis and Waldenström's macroglobulinaemiae.

• Authors: Y Kihara, H Hori, H Murakami, Y Hatakeyama, I Yoshikawa, T Hamada, M Otsuki
• Journal: Journal of internal medicine (J Intern Med) Vol. 252 Issue 3 Pg. 255-8 (Sep 2002) ISSN: 0954-6820 [Print] England
• PMID: 12270006 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulin M
• Immunoglobulin kappa-Chains

Topics

• Aged
• Amyloidosis (complications, diagnosis)
• Bone Marrow (pathology)
• Fatal Outcome
• Humans
• Immunoglobulin M (blood)
• Immunoglobulin kappa-Chains (blood)
• Jejunum (pathology)
• Lymphocytes (pathology)
• Male
• POEMS Syndrome (complications, diagnosis)
• Peripheral Nerves (pathology)
• Plasma Cells (pathology)
• Waldenstrom Macroglobulinemia (blood, complications, diagnosis)