POEMS综合征二例误诊原因分析及文献复习

Analysis of Misdiagnosis Causes and Literature Review of 2 Patients with POEMS Syndrome

目的提高POEMS综合征的诊断水平,避免误诊和漏诊并文献复习。方法回顾性分析2例POEMS综合征的临床资料。结论 1例表现为高血糖,下肢无力、麻木并水肿,皮肤色素沉着及变硬,肝脾大等,先后误诊为Guillain-Barre综合征、Budd-Chiari综合征。1例表现为头痛、下肢无力、视物模糊、皮肤色素沉着等,先后误诊为颅内静脉窦血栓形成、神经Betch病。入我院后经多专科会诊,全面检查,均符合POEMS综合征诊断标准,予免疫抑制剂治疗,症状缓解。结论 POEMS综合征病情复杂且进展缓慢,早期容易误诊,近20年来其诊断标准不断更新,临床医师应学习掌握。

Objective To improve the diagnosis level of POEMS syndrome and review the literature so as to avoid misdiag- nosis and missed diagnosis. Methods Clinical data of 2 patients with POEMS syndrome was retrospectively analyzed. Results One patient had hyperglycemia, lower extremity weakness, numbness and edema, skin pigmentation and hardened, hepatospleno- megaly, etc. The patient was misdiagnosed as having Guillain-Barre syndrome and Budd Chiari syndrome. Another patient had headache, lower extremity weakness, blurred vision, skin pigmentation, etc. another patient was misdiagnosed as having intracranial venous sinus thrombosis and Betch nerve disease. The two patients were confirmed with POEMS syndrome after admission in our hospital by several specialist consultation and comprehensive examinations, and the patients＇symptoms were relieved after immuno- suppressant treatment. Conclusion Pathogenetie condition of POEMS syndrome is complex with slow progress, so it can be easily misdiagnosed.