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Cerebral infarction in POEMS syndrome: incidence, risk factors, and imaging characteristics

S A Dupont1, A Dispenzieri, M L Mauermann

  • 1Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA. dupont.stefan@mayo.edu

Neurology
|October 21, 2009
PubMed

Insights

Patients with POEMS syndrome face a significant risk of cerebral infarction, particularly those with elevated platelet counts and bone marrow plasmacytosis. Aggressive management of stroke risk factors and POEMS syndrome treatment are crucial.

Area of Science:

  • Neurology
  • Hematology
  • Oncology

Background:

  • POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) is a rare multisystem disorder.
  • Cerebral infarction is a serious complication, but its risk factors and incidence in POEMS syndrome are not well-established.

Purpose of the Study:

  • To determine the incidence and risk factors of cerebral infarction in patients diagnosed with POEMS syndrome.
  • To identify predictors of stroke in this specific patient population.

Main Methods:

  • Retrospective observational study utilizing the Mayo Clinic dysproteinemia database.
  • Identification of patients with POEMS syndrome and subsequent cerebral infarction after symptom onset.
  • Evaluation of potential stroke predictors, including hematologic abnormalities and traditional risk factors.

Main Results:

  • Cerebral infarction occurred in 10% of POEMS syndrome patients, with a 5-year risk of 13.4%.
  • Hematologic abnormalities, specifically elevated platelet count and bone marrow plasmacytosis, were associated with increased stroke risk.
  • Traditional stroke risk factors were not significantly different between stroke and non-stroke subgroups.
  • Infarct etiologies included vascular abnormalities (dissection, stenosis) and embolism.

Conclusions:

  • Plasma cell proliferation and thrombocytosis are key risk factors for cerebral infarction in POEMS syndrome.
  • Aggressive management of modifiable stroke risk factors is recommended.
  • Treatment of thrombocytosis and the underlying POEMS syndrome may reduce the risk of cerebral infarction.
Abstract

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