POEMS syndrome: cryoglobulinemia an unusual association

Associations between plasma cell dyscrasia and peripheral neuropathy were well recognized as early as the 1950s. In 1980, Bardwick coined the acronym POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes).

We report a 56-year-old woman who presented with excessive sweating, lethargy, intermittent clawing of fingers and painful limb spasms for 2 years. Clinical examination showed hyperpigmented skin lesions, bilateral pleural effusions and organomegaly. Relevant investigations revealed the presence of sensorimotor polyneuropathy, raised cerebrospinal fluid protein, IgM monoclonal band on serum protein electrophoresis, and reactive bone marrow. The patient was treated with combination therapy which included cyclophosphamide, dexamethasone, and intravenous immunoglobulin with moderate response.

Presence of cryoglobulinemia in this case has not been described in the literature.