Chylothorax in POEMS syndrome.

Area of Science:

• Medicine
• Pulmonology
• Hematology

Background:

• Chylothorax, characterized by lymphatic fluid in the pleural space, has diverse etiologies including malignancy, trauma, and infection.
• POEMS syndrome is a rare multisystemic disorder linked to plasma cell dyscrasias, typically presenting with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes.

Observation:

• A 61-year-old female presented with dyspnea and edema, later diagnosed with bilateral pleural effusion and chylothorax.
• Despite extensive workup, the etiology of chylothorax remained unclear, with initial treatments proving ineffective.
• Subsequent investigations revealed characteristic features of POEMS syndrome, including endocrinopathy, monoclonal plasma cell disorder, neuropathy, and elevated vascular endothelial growth factor.

Findings:

• This case represents the first documented association between POEMS syndrome and chylothorax.
• The patient's chylothorax was ultimately managed with pleurodesis.
• POEMS syndrome, though rare, should be considered in the differential diagnosis of idiopathic chylothorax.

Implications:

• This report highlights the importance of considering POEMS syndrome in patients with unexplained chylothorax.
• Early diagnosis and management of POEMS syndrome can lead to better patient outcomes.
• Further research is warranted to understand the pathophysiology linking POEMS syndrome and chylothorax.