双下肢麻木、无力1年,加重6个月

Numbness and weakness of both lower extremities for 1 year,aggravated for 6 months

POEMS综合征是一组单克隆浆细胞导致的综合征,由于涉及多发神经病变、器官肿大、内分泌异常、单克隆免疫球蛋白、皮肤改变等,患者可能首诊自不同的科室,往往不能得到及时的诊断。本例患者首诊于脊柱外科,以椎管狭窄收入院,经过检查,发现了单克隆的免疫球蛋白,怀疑多发性骨髓瘤,转入血液科后完善骨髓等检查,排除了多发性骨髓瘤,最终依赖PET/CT的提示,确诊为POEMS综合征。经来那度胺、地塞米松组成的RD方案治疗后,患者症状明显好转。

POEMS syndrome is a syndrome caused by a group of monoclonal plasma cells.Because it involves multiple neuropathies,organ enlargement,endocrine abnormalities,monoclonal immunoglobulin,skin changes,etc.,patients may first be diagnosed from different departments,and often cannot be diagnosed in time.This patient was first diagnosed in spinal surgery and admitted to the hospital with spinal stenosis.After screening,monoclonal immunoglobulin was found.After multiple myeloma was suspected to be transferred to the hematology department,bone marrow and other examinations were improved,multiple myeloma was excluded,and finally,depending on the indications of PET/CT,POEMS syndrome was diagnosed.After treatment with RD regimen composed of lenalidomide and dexamethasone,the patient’s symptoms improved significantly.