POEMS syndrome

• Polyneuropathy, Osteosclerosis, Endocrinopathy, M-protein, Skin changes.

• Association of plasmacytoma with chronic inflammatory demyelinating polyneuropathy causing predominantly motor disability.

• Confirm diagnosis by demonstrating monoclonal plasma cells in osteosclerotic bone lesion (plasmacytoma).

• BM usually <5% plasma cells; low level paraprotein; hypercalcaemia and renal impairment rare.

• Other features: lymphadenopathy, organomegaly, diabetes mellitus, male gynaecomastia and impotence, female amenorrhoea, hypertrichosis and hyperpigmentation.

• Treat solitary bone lesions with aggressive radiotherapy (45Gy) ± surgery.

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