误诊为慢性格林巴利的POEMS综合征1例

A case of POEMS syndrome misdiagnosed as chronic inflammatory demyelinating polyneuropathy

对2018年北京中医药大学东方医院1例POEMS综合征患者的临床资料进行回顾性分析,探讨该病诊断和治疗。多发性周围神经病是POEMS综合征患者主要临床表现,又常是首发症状,该病患者几乎全部具有慢性炎症性脱髓鞘性多发性神经病变(CIDP),患者脑脊液蛋白细胞分离现象,极易误诊。及早治疗有利于减轻病损程度、增加生存率,故早期确诊意义重大。本患者被误诊为CIDP两年半,期间出现多系统症状,辗转于多家医院多个科室就诊,一直没有被正确诊断,患者身心煎熬,病痛缠身,耗费大量人力、物力、财力。希望本病例报道结合复习文献能够帮助指导临床医师尽早正确诊断出POEMS综合征患者,使患者最大受益。

The clinical data of a case of retroperitoneal schwannoma in the Dongfang Hospital Attached to Beijing U-niversity of Traditional Chinese Medicine in 2018 were analyzed retrospectively in order to investigate the diagnosis and treatment of POEMS syndrome.Multiple peripheral neuropathy is not only the main clinical manifestation of PO-EMS syndrome patients,but also the first symptom.Almost all patients with this disease have the protein cell separa-tion phenomenonin in the cerebrospinal fluid,which is easy to be misdiagnosed with chronic inflammatory demyelinat-ing polyneuropathy(CIDP).Early treatment is beneficial to reduce the degree of disease damage and increase the sur-vival rate,so early diagnosis is very important.This patient was misdiagnosed as CIDP for two and a half years.During this period,the patient developed multiple system symptoms,and went to many departments of many hospitals for treatment.While,the patient was not diagnosed correctly all the time.The patient was suffering physically and mental-ly,which cost a lot of human,material and financial resources.In this study,the case report combined with literature review can help guide clinicians to correctly diagnose patients with POEMS syndrome as soon as possible,so that pa-tients can benefit the most.