POEMS syndrome: a unique presentation and a diagnostic challenge

Area of Science:

• Neurology
• Oncology

Background:

• POEMS syndrome is a rare multisystem disorder.
• It can present with diverse neurological symptoms, including myositis and polyneuropathy.

Observation:

• A 70-year-old female presented with gait deterioration and MRI findings suggestive of myositis.
• Muscle biopsy and nerve conduction studies revealed neurogenic amyotrophy and mixed sensorimotor polyneuropathy.

Findings:

• Positron emission tomography scan identified a hip lesion, biopsied as a plasmacytoma.
• Despite normal serum protein electrophoresis, the findings confirmed POEMS syndrome.

Implications:

• Delayed diagnosis of POEMS syndrome can lead to irreversible neurological damage and dependence.
• This case highlights the importance of considering POEMS syndrome in patients with unexplained myositis and polyneuropathy, even with atypical initial findings.