Heavy metals intoxication in a patient with POEMS-like symptoms: a case report

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) is a kind of plasma cell disease with complex clinical manifestations involving multiple systems. Metal poisonings through a mucocutaneous are rare in clinic and reported less in the literature. People may exposure to toxic metals through air, food, water, or inappropriate use of drugs. Acute or chronic poisonings can lead to various toxic effects on body tissues and organs. Both POEMS syndrome and heavy metal intoxication are uncommon with multifarious and nonspecific clinical manifestations. Here we describe a case of a 54-year-old man with polyarticular pain and IgA lambda type monoclonal protein in his serum. The diagnosis was confirmed by heavy metals testing in his urine and the herbal mixtures he took. This is the first available report of arsenic and mercury intoxication mimicking POEMS syndrome.