Muscle cramping over the diagnosis

Area of Science:

• Endocrinology
• Neurology
• Oncology

Background:

• POEMS syndrome is a rare multisystem disorder.
• It is characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes.
• Optic disc edema is a recognized but less common manifestation.

Observation:

• A 44-year-old man with hypogonadism and adrenal insufficiency presented with transient blurred vision and halos.
• He exhibited mild bilateral optic disc edema, elevated cerebrospinal fluid pressure, and protein.
• Spinal MRI revealed heterogeneous bone marrow signal and a femoral plasmacytoma.

Findings:

• The patient was diagnosed with POEMS syndrome based on clinical and imaging findings.
• Elevated vascular endothelial growth factor (VEGF) was noted.
• Treatment with radiation to the plasmacytoma led to stable neuro-ophthalmologic status at two years.

Implications:

• This case highlights the importance of considering POEMS syndrome in patients with unexplained optic disc edema and endocrinopathies.
• Prompt identification and management of the underlying plasmacytoma are essential.
• Effective treatment can lead to stabilization of neurological and ophthalmological symptoms.