POEMS syndrome other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]
Overview
Other diagnostic studies that can help in making the diagnosis of POEMS syndrome include nerve conduction study, electromyography, fundoscopy, serum plasma electrophoresis and immunofixation electrophoresis, laboratory evaluation for endocrinopathies, visual field testing, fluorescein angiography, bone marrow biopsy, and pulmonary function test.
Other Diagnostic Studies
Given below are the other diagnostic studies with their corresponding findings in POEMS syndrome:
Electromyography and Nerve Conduction Study
- Reduced compound muscle action potential (CMAP)[1][2][3]
- Reduced motor conduction velocity (MCV) (normal mean value: 50-60 meters/second)[1][2][3]
- Significantly higher terminal latency index (TLI)[1][2][3]
Serum Plasma Electrophoresis and Immunofixation Electrophoresis
- IgG-λ and IgA-κ biclonal gammopathy[9][10]
- Increased serum free light chain κ and λ values[9]
- Higher than normal κ/λ ratio[9]
Visual Field Testing
- Field defects[11]
Fluorescein Angiography
- May reveal pooling of fluid consistent with cystoid macular edema[11][12]
Fundoscopy
- Optic disc swelling[12]
- Optic disc hemorrhages[12]
- Serous macular detachments[12]
Laboratory Evaluation for Endocrinopathies
- Decreased testosterone level[8][4]
- Decreased LH, and estradiol levels[13]
- High or low FSH level[14]
- Elevated thyroid stimulating hormone (TSH) level[4]
- Decreased cortisol level[15][16]
- Elevated prolactin level[17]
- Elevated fasting blood glucose level[18][17][19]
Complete Blood Count Bone Marrow Biopsy
- Increased number of plasma cells[20]
Pulmonary Function Test
References
- ↑ 1.0 1.1 1.2 Kim H, Lim YM, Jin JY, Yoon DH, Suh C, Kim SY, Jo JC, Kim KK (December 2017). "Electrophysiologic features of POEMS syndrome compared with MGUS-related neuropathy". Muscle Nerve. 56 (6): E73–E77. doi:10.1002/mus.25684. PMID 28472865.
- ↑ 2.0 2.1 2.2 2.3 Liu M, Zou Z, Guan Y, Li J, Zhou D, Cui L (January 2015). "Motor nerve conduction study and muscle strength in newly diagnosed POEMS syndrome". Muscle Nerve. 51 (1): 19–23. doi:10.1002/mus.24267. PMID 24752623.
- ↑ 3.0 3.1 3.2 Xu Y, Song H, Zhang S, Fan D (February 2014). "[Neurophysiologic studies of POEMS syndrome and its related diseases]". Zhonghua Yi Xue Za Zhi (in Chinese). 94 (5): 356–8. PMID 24746082.
- ↑ 4.0 4.1 4.2 Ayala-Hernández I, Martínez-González M, Halabe-Cherem J (1999). "[POEMS syndrome. Report of a case]". Gac Med Mex (in Spanish; Castilian). 135 (3): 311–5. PMID 10425826.
- ↑ Abbas A, Cook M, Hiew FL, Lewthwaite A, Shirley C, Rajabally YA (October 2016). "A case of POEMS mimicking a "Guillain-Barré like" syndrome". J. Neurol. Sci. 369: 268–270. doi:10.1016/j.jns.2016.08.027. PMID 27653904.
- ↑ Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK (April 2015). "POEMS syndrome with peripheral and central nervous system demyelination: case report". Neurologist. 19 (4): 101–3. doi:10.1097/NRL.0000000000000017. PMID 25888197.
- ↑ Guo X, Qin X, Zhang Y, Huang C, Yu G (April 2014). "Electrophysiological features of POEMS syndrome and chronic inflammatory demyelinating polyneuropathy". J Clin Neurosci. 21 (4): 587–90. doi:10.1016/j.jocn.2013.05.023. PMID 24268501.
- ↑ 8.0 8.1 Pinto Neto, Jorge V. (2007). "Síndrome de POEMS (mieloma osteoesclerótico)". Revista Brasileira de Hematologia e Hemoterapia. 29 (1). doi:10.1590/S1516-84842007000100018. ISSN 1516-8484.
- ↑ 9.0 9.1 9.2 Ham JY, Suh JS, Lee WK, Song KE (2015). "POEMS Syndrome with IgG-λ/IgA-κ Biclonal Gammopathy and Abnormal Serum Free Light Chain Ratio: a Case Report". Ann. Clin. Lab. Sci. 45 (6): 702–6. PMID 26663802.
- ↑ De D, Halder S, Datta SS (July 2017). "POEMS Syndrome with Biclonal Gammopathy: A Rare Association". J Clin Diagn Res. 11 (7): XD12–XD13. doi:10.7860/JCDR/2017/24800.10265. PMC 5583889. PMID 28893029.
- ↑ 11.0 11.1 Gutierrez-Ortiz C, Castro-Rebollo M, Pareja J, Beckford C, Teus M (2009). "Bilateral non-simultaneous optic neuropathy and unilateral macular edema in a patient with POEMS syndrome". Eur J Ophthalmol. 19 (1): 166–9. PMID 19123170.
- ↑ 12.0 12.1 12.2 12.3 Okada K, Yamamoto S, Tsuyama Y, Mizunoya S (2007). "Case of POEMS syndrome associated with bilateral macular detachment resolved by autologous peripheral blood stem cell transplantation". Jpn. J. Ophthalmol. 51 (3): 237–8. doi:10.1007/s10384-006-0428-8. PMID 17554492.
- ↑ Zaidi S, Sattar S, Asumal KB (October 2017). "An Adult with Polyneuropathy and Hypogonadism due to Poems Syndrome". J Coll Physicians Surg Pak. 27 (10): 651–653. doi:2728 Check
|doi=value (help). PMID 29056130. - ↑ Shichiri M, Iwashina M, Imai T, Marumo F, Hirata Y (February 1998). "Abnormal FSH hypersecretion as an endocrinological manifestation of POEMS syndrome". Endocr. J. 45 (1): 131–4. PMID 9625458.
- ↑ Mauvais-Jarvis F, Bertherat J, Ravaud H, Thomopoulos P, Luton JP (January 1998). "[POEMS syndrome with primary adrenocortical insufficiency]". Presse Med (in French). 27 (1): 15–7. PMID 9767755.
- ↑ Gandhi GY, Basu R, Dispenzieri A, Basu A, Montori VM, Brennan MD (July 2007). "Endocrinopathy in POEMS syndrome: the Mayo Clinic experience". Mayo Clin. Proc. 82 (7): 836–42. doi:10.4065/82.7.836. PMID 17605964.
- ↑ 17.0 17.1 Caimari F, Keddie S, Lunn MP, D'Sa S, Baldeweg SE (September 2018). "Prevalence and course of endocrinopathy in POEMS syndrome". J. Clin. Endocrinol. Metab. doi:10.1210/jc.2018-01516. PMID 30239770.
- ↑ Hu P, Luo YY, Wu J, Gao LL (December 2017). "[Analysis of clinical features of 23 patients with POEMS syndrome]". Beijing Da Xue Xue Bao (in Chinese). 49 (6): 985–989. PMID 29263469.
- ↑ Mano T, Mori K, Sawai Y, Oda N, Tugawa T, Nakano I, Watanabe F, Hamada M, Nakai A, Yamamoto H, Harada N, Nagasaka A, Itoh M (1999). "Accelerated conversion of dehydroepiandrosterone sulfate to estrogen in a patient with Crow-Fukase syndrome and diabetes mellitus". Endocr. Res. 25 (3–4): 371–80. PMID 10596729.
- ↑ Takatsuki K, Sanada I (September 1983). "Plasma cell dyscrasia with polyneuropathy and endocrine disorder: clinical and laboratory features of 109 reported cases". Jpn. J. Clin. Oncol. 13 (3): 543–55. PMID 6315993.
- ↑ Chandrashekaran S, Dispenzieri A, Cha SS, Kennedy CC (January 2015). "Pulmonary morbidity improves after autologous stem cell transplantation in POEMS syndrome". Respir Med. 109 (1): 122–30. doi:10.1016/j.rmed.2014.11.005. PMC 4758677. PMID 25433952.