June 2018 — Hematopathology

A 49-year-old male with prior history of severe progressive peripheral neuropathies in his extremities was diagnosed at an outside institution with chronic inflammatory demyelinating polyneuropathy. Treatments with steroids, intravenous immunoglobulins, immunosuppressants, and plasma exchange had been ineffective. The patient also underwent trial autologous bone marrow transplantation, but his neuropathies continued to worsen. In addition to splenomegaly, he developed several endocrinopathies. An alternative diagnosis of POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monocloncal plasmaproliferative disorder, and skin changes) was considered. The patient presented to Mayo Clinic for further management. Subsequent investigations supported the POEMS diagnosis.

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Abdulrahman Saadalla, M.B., B.Ch.
Resident, Clinical Pathology
Mayo Clinic
Phuong Nguyen, M.D
Consultant, Hematopathology
Mayo Clinic
Associate Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine

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