Nomura Taichi, Iwata Ikuko, Eguchi Katsuki, Fujii Shintaro, Inoue Takashi, Tarisawa Monami, Ishio Takashi, Toyama Yuichiro, Uwatoko Hisashi, Shirai Shinichi, Matsushima Masaaki, Yaguchi Hiroaki, Yabe Ichiro
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan.
Department of Neurology, Hokuyukai Neurological Hospital, Japan.
Intern Med. 2025 Mar 1;64(5):769-773. doi: 10.2169/internalmedicine.4086-24. Epub 2024 Aug 1.
POEMS syndrome is often associated with a poor prognosis. Elevated serum vascular endothelial growth factor (sVEGF) is a useful diagnostic marker with high sensitivity and specificity. However, the relationship between sVEGF elevation and polyneuropathy in POEMS syndrome remains controversial. We herein report a case of polyneuropathy without sVEGF elevation at the first admission. However, at 21 months after the onset, the patient tested positive for sVEGF and was diagnosed with POEMS syndrome. Therefore, it is important to repeatedly measure sVEGF levels in patients with polyneuropathy with an atypical course when POEMS syndrome is suspected, even if the initial sVEGF level is normal.
POEMS综合征通常预后较差。血清血管内皮生长因子（sVEGF）升高是一种具有高敏感性和特异性的有用诊断标志物。然而，POEMS综合征中sVEGF升高与多发性神经病之间的关系仍存在争议。我们在此报告一例首次入院时多发性神经病但sVEGF未升高的病例。然而，发病21个月后，患者sVEGF检测呈阳性，并被诊断为POEMS综合征。因此，对于疑似POEMS综合征且病程不典型的多发性神经病患者，即使初始sVEGF水平正常，反复测量sVEGF水平也很重要。
