Department of Neurology, Japanese Red Cross Medical Center, Japan.
Department of Hematology, Japanese Red Cross Medical Center, Japan.
Intern Med. 2023 Feb 1;62(3):475-479. doi: 10.2169/internalmedicine.9101-21. Epub 2022 Jul 14.
A 36-year-old man developed polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome after conversion from solitary plasmacytoma of bone to multiple myeloma. Twenty-four days following the neurological onset, he lost his independent walking ability. The level of serum vascular endothelial growth factor (VEGF) at diagnosis was 5,250 pg/mL. Three months after initiating treatment, he regained his independent walking ability in line with a reduction in the elevated serum VEGF level. Due to their genomic instability gained during conversion, myeloma cells may overproduce humoral factors and cytokines, possibly contributing to the development of neuropathy as well as the production of VEGF.
一位 36 岁男性患者,由孤立性浆细胞瘤转化为多发性骨髓瘤后出现多发性神经病、器官肿大、内分泌病、M 蛋白和皮肤改变(POEMS)综合征。神经病发作后 24 天,他失去了独立行走的能力。诊断时血清血管内皮生长因子(VEGF)水平为 5250pg/ml。开始治疗 3 个月后,随着血清 VEGF 水平升高的降低,他恢复了独立行走的能力。由于在转化过程中获得了基因组不稳定,骨髓瘤细胞可能会过度产生体液因子和细胞因子,这可能有助于神经病的发展以及 VEGF 的产生。