POEMS综合征合并急性脑梗塞

Acute Cerebral Infarction in POEMS Syndrome

目的 观察和探讨POEMS综合征与急性脑梗塞的内在相关性。方法 报道 1例确诊为POEMS综合征的男性病人 ,在病后半年突然出现左侧肢体完全偏瘫 ,通过对临床、血液有形成分、电生理及影像学进行研究。结果 血红细胞、血红蛋白、血小板计数及血细胞压积明显增高 ,肌电图显示广泛神经传导速度减慢 ,骨盆片可见骨硬化病灶 ,头颅MRI显示右侧大脑颞、额、顶、枕大面积脑梗塞。结论 POEMS综合征可以引起广泛的血管病变包括大血管、中小血管及毛细血管 ,成为导致血管闭塞的直接原因 ,而微血管病变可能在POEMS综合征的发病机制中起重要作用。

Objective To observe and study the relationship between acute cerebral infarction and POEMS syndrome. Methods Fourty four year old man with typical POEMS syndrome developed acute cerebral thrombosis next 6 months after diagnosis. Clinical, blood cell, electrophysiological and radiological manifestations were studied. Results The blood red cell, hematoglobin, platelet counts were elevated. Electromyograph finding revealed that motor and sensory conduction velocity was reduced, radiograph of pelvis showed osteosclerotic lesion. MRI examination showed a large ischemic area of in right cerebrosphere. Conclusion Vasculature of various sizes are affected in POEMS syndrome. Vaculopathy may be important in the pathogenesis of POEMS syndrome.