ntroducing a ۳۲-year-old female patient with POEMS syndrome

مقدمه/ بیان مساله: POEMS syndrome is a multisystem disorder associated with polyneuropathy, organomegaly, endocrinopathy, a monoclonal protein (M-protein), and skin changes. Multiple myeloma accounts for approximately ۱۰% of all hematologic malignancies. multiple myeloma is more common in men than women, and occurs more frequently between the ages of ۶۵–۷۴ years..معرفی بیمار : A ۳۲-year-old female patient with a history of hypothyroidism who started complaining of pelvic pain about a year ago. His pain was bilateral, but it was more severe on the right side,the patient also complained of feeling weak in the lower limbs. She has a history of vitiligo after pregnancy ۶ years ago.In addition to vitiligo, the patient has had painful skin lesions in the form of purulent and hemorrhagic folliculitis in the upper limbs and lumbar region. Associated symptoms include loss of appetite, weight loss of about ۶ kg in the last ۶ months, night sweats, bone pain, feeling of muscle weakness, and lameness of the right leg. The patient's menstrual period has been irregular. In the examination she was alert and oriented. The described skin lesions were evident. The patient's vital signs were normal. Heart and lung examinations were normal. Muscle forces of the upper and lower limbs on both sides were decreased. DTR of upper and lower limbs is reduced. In the initial tests she has hemoglobin:۸, leukocytosis and thrombocytosis with ESR ۹۸. Creatinine was ۰.۶, calcium ۱۰.۱ and INR ۱.۵ were reported Monoclonal gammopathy was reported in serum protein electrophoresis and consistent with plasma cell neoplasm in bone marrow biopsy. Hepatosplenomegaly was reported in ultrasound. In MRI, periosteal reaction was reported in the anterior surface of the sacrum and bilateral iliac. Finally, with the diagnosis of multiple myeloma in BMA/B, the patient underwent chemotherapy with Velcade, zomata, dexamethasone chemotherapy regimen, and due to polyneuropathy, organomegaly, hypothyroidism, multiple myeloma, and skin lesions, the diagnosis of POEMS syndrome was confirmed for the patient.

کلیدواژه ها:

polyneuropathy ، organomegaly ، endocrinopathy ، Mutiple myeloma ، vittiligo