[Two cases of POEMS syndrome with increased vascular endothelial growth factor (VEGF)].

We report a greatly increased amount of vascular endothelial growth factor (VEGF) in sera of two cases with POEMS syndrome. They had solitary myelomas in the cervical (case 1) and lumbar vertebrae (case 2). In both cases, serum VEGF decreased after steroid therapy. Sural nerve biopsy in case 1 showed marked subperineurial edema. The pathomechanism of polyneuropathy in POEMS syndrome may be due to involvement of the blood-nerve barrier by way of increased microvascular permeability induced by VEGF. VEGF is therefore not only a useful diagnostic marker for POEMS syndrome, but may also be a marker of clinical improvement.