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Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Protein, and Skin Changes (POEMS) Syndrome in the Middle East: A Case Report

2025Open accessAlexandria University

Abstract

POEMS syndrome is a rare paraneoplastic syndrome characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal protein gammopathy, and skin changes. We report the first case of POEMS syndrome in Egypt. We report a 37-year-old Egyptian male who presented with left lower limb pain, numbness, weight loss, and urinary incontinence. Laboratory evaluation revealed monoclonal IgA lambda bands and 10\% plasma cells on bone marrow aspiration. Nerve conduction studies confirmed severe sensory-motor polyneuropathy with axonal degeneration. Bone scan showed sclerotic changes, and imaging revealed hepatosplenomegaly. The patient met the diagnostic criteria for POEMS syndrome and was treated with the VRD protocol. Follow-up over 23 months showed declining M-band levels with eventual normalization. However, β2-microglobulin levels rose. The patient achieved a partial response and was referred for autologous bone marrow transplantation. This represents the first reported case of POEMS syndrome in Egypt, emphasizing the need for clinical awareness in non-endemic regions. A multidisciplinary approach is essential for optimal management. Further studies are needed to explore the presentation and management of POEMS syndrome in the Middle East and North Africa region.

Research topics

  • Peripheral Neuropathies and Disorders
  • Hereditary Neurological Disorders
  • Autoimmune Bullous Skin Diseases

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DOI: 10.71079/aside.cr.091725195

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