Vascular endothelial growth factors (VEGF) as a major parameter for diagnosis and follow up of a patient with POEMS syndrome

POEMS syndrome, also termed osteosclerotic myeloma, is a rare multi system disorder including polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin lesions. Increased level of cytokines, specifically serum VEGF, seems to have a role in the disease pathogenesis. We present a patient with polyneuropathy and a lytic (not sclerotic) plasmacytoma that was diagnosed with POEMS syndrome. In this case VEGF served as a major diagnostic criterion. Following treatment, VEGF proved to be an important biological marker for therapeutic response, which preceded the clinical response. We conclude that in patients with polyneuropathy, evaluation of serum VEGF levels should be part of the initial workup to shorten time to diagnosis and improve disease management.