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Related Experiment Videos

When do optic disc edema and peripheral neuropathy constitute poetry?

P W Brazis1, T J Liesegang, J P Bolling

  • 1Department of Neurology, Mayo Clinic Jacksonville, Florida.

Survey of Ophthalmology
|November 1, 1990
PubMed
Summary

Optic disc edema can be the initial sign of POEMS syndrome, a rare disorder. This case highlights the importance of recognizing POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) and osteosclerotic myeloma in patients with unexplained visual changes.

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Area of Science:

  • Neurology
  • Oncology
  • Ophthalmology

Background:

  • POEMS syndrome is a rare multisystem disorder characterized by polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes.
  • Optic disc edema is a potential, though less common, presenting symptom of POEMS syndrome.

Observation:

  • A patient presented with chronic, bilateral optic disc edema.
  • The patient subsequently developed systemic manifestations consistent with POEMS syndrome.

Findings:

  • Serum and urine immunoelectrophoresis identified abnormal IgG lambda protein and a monoclonal lambda protein.
  • Imaging revealed a sclerotic lesion in the first lumbar vertebra, and lymph node biopsy was consistent with Castleman's disease.
  • These findings confirmed the diagnosis of POEMS syndrome with an associated osteosclerotic myeloma.

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Implications:

  • This case underscores that optic disc edema can be the primary presenting feature of POEMS syndrome.
  • Early recognition and diagnosis of POEMS syndrome are crucial for timely management and improved patient outcomes.
  • The association with osteosclerotic myeloma highlights the need for comprehensive evaluation in patients with POEMS syndrome.