Case report: POEMS syndrome masquerades as diabetic foot
We present the case of a 54-year-old woman with reasonable blood sugar control who presented with a diabetic foot combined with severe peripheral neuropathy and vascular disease. Lower limb muscle weakness, muscle atrophy, skin pigmentation, and emaciation were also observed. Although her muscle str...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1336382/full |
| _version_ | 1797346247285145600 |
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| author | Guang-Xin Zhou Li Xiao Yong-Min Bi Fen Yang Cai-Zhe Yang Da Zhang |
| author_facet | Guang-Xin Zhou Li Xiao Yong-Min Bi Fen Yang Cai-Zhe Yang Da Zhang |
| author_sort | Guang-Xin Zhou |
| collection | DOAJ |
| description | We present the case of a 54-year-old woman with reasonable blood sugar control who presented with a diabetic foot combined with severe peripheral neuropathy and vascular disease. Lower limb muscle weakness, muscle atrophy, skin pigmentation, and emaciation were also observed. Although her muscle strength improved after glucocorticoid treatment, it remained challenging to account for the other symptoms in this particular patient with chronic inflammatory demyelinating polyneuropathy. Plump liver and spleen, hidden bone lesions combined with seemingly unexplained cerebral infarction, and serous effusion led us to suspect polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. The abnormal proliferation of monoclonal plasma cells and a significant increase in vascular endothelial growth factor (VEGF) levels confirmed the diagnosis of POEMS syndrome. After 1 month of treatment with lenalidomide and dexamethasone, the diabetic foot ulcers healed, and the symptoms of myasthenia and fatigue improved. Diabetic feet may represent only the tip of the iceberg of an underlying POEMS syndrome. Our report aimed to increase awareness of this rare yet significant situation, advocating for the prompt identification and treatment of POEMS syndrome. |
| first_indexed | 2024-03-08T11:29:16Z |
| format | Article |
| id | doaj.art-a185120e4dba4dc2bf2b11e5735626dd |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-08T11:29:16Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-a185120e4dba4dc2bf2b11e5735626dd2024-01-26T04:22:18ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-01-011410.3389/fneur.2023.13363821336382Case report: POEMS syndrome masquerades as diabetic footGuang-Xin Zhou0Li Xiao1Yong-Min Bi2Fen Yang3Cai-Zhe Yang4Da Zhang5Department of Endocrinology, Air Force Medical Center, Air Force Medical University, Beijing, ChinaDepartment of Endocrinology, Air Force Medical Center, Air Force Medical University, Beijing, ChinaDepartment of Nuclear Medicine, Air Force Medical Center, Air Force Medical University, Beijing, ChinaDepartment of Neurology, Air Force Medical Center, Air Force Medical University, Beijing, ChinaDepartment of Endocrinology, Air Force Medical Center, Air Force Medical University, Beijing, ChinaDepartment of Endocrinology, Air Force Medical Center, Air Force Medical University, Beijing, ChinaWe present the case of a 54-year-old woman with reasonable blood sugar control who presented with a diabetic foot combined with severe peripheral neuropathy and vascular disease. Lower limb muscle weakness, muscle atrophy, skin pigmentation, and emaciation were also observed. Although her muscle strength improved after glucocorticoid treatment, it remained challenging to account for the other symptoms in this particular patient with chronic inflammatory demyelinating polyneuropathy. Plump liver and spleen, hidden bone lesions combined with seemingly unexplained cerebral infarction, and serous effusion led us to suspect polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. The abnormal proliferation of monoclonal plasma cells and a significant increase in vascular endothelial growth factor (VEGF) levels confirmed the diagnosis of POEMS syndrome. After 1 month of treatment with lenalidomide and dexamethasone, the diabetic foot ulcers healed, and the symptoms of myasthenia and fatigue improved. Diabetic feet may represent only the tip of the iceberg of an underlying POEMS syndrome. Our report aimed to increase awareness of this rare yet significant situation, advocating for the prompt identification and treatment of POEMS syndrome.https://www.frontiersin.org/articles/10.3389/fneur.2023.1336382/fulldiabetic footPOEMS syndromeperipheral neuropathyendocrinological manifestationsmuscle weakness |
| spellingShingle | Guang-Xin Zhou Li Xiao Yong-Min Bi Fen Yang Cai-Zhe Yang Da Zhang Case report: POEMS syndrome masquerades as diabetic foot Frontiers in Neurology diabetic foot POEMS syndrome peripheral neuropathy endocrinological manifestations muscle weakness |
| title | Case report: POEMS syndrome masquerades as diabetic foot |
| title_full | Case report: POEMS syndrome masquerades as diabetic foot |
| title_fullStr | Case report: POEMS syndrome masquerades as diabetic foot |
| title_full_unstemmed | Case report: POEMS syndrome masquerades as diabetic foot |
| title_short | Case report: POEMS syndrome masquerades as diabetic foot |
| title_sort | case report poems syndrome masquerades as diabetic foot |
| topic | diabetic foot POEMS syndrome peripheral neuropathy endocrinological manifestations muscle weakness |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1336382/full |
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