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Neurological impairment in a patient with concurrent cervical disc herniation and POEMS syndrome

  • Tingxian Ling
  • Limin Liu
  • Yueming Song
  • Shilian Zhou
  • Chunguang ZhouEmail author
Case Report

Abstract

Purpose

POEMS syndrome is a rare clonal plasma cell disease characterized by polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes. We report a rare case of neurological impairment in patients with concurrent cervical disc herniation and POEMS syndrome.

Methods

A patient presented to a local hospital with C3/4 and C4/5 disc herniation, apparent spinal cord compression concomitant with neurological signs, and concurrent POEMS syndrome. Anterior cervical discectomy and fusion was performed.

Results

The limb numbness was only slightly alleviated, and 10 days postoperatively the patient complained of muscle weakness of the extremities and was referred to our hospital. The patients exhibited non-typical neurological signs and an enlarged liver and spleen that could not be explained. Electroneuromyography and immunofixation electrophoresis produced abnormal results. We diagnosed concurrent POEMS syndrome, for which drug therapy was prescribed. The patient’s symptoms receded.

Conclusion

Patients presenting with cervical spondylopathy and non-typical neurological signs and symptoms or other systemic problems should be evaluated for the presence of concurrent disease and ruled out differential diagnoses.

Keywords

Neurological impairment POMES syndrome Cervical disc herniation Cervical spondylosis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Lubelski D, Healy AT, Silverstein MP, Alvin MD, Abdullah KG, Benzel EC, Mroz TE (2015) Association of postoperative outcomes with preoperative magnetic resonance imaging for patients with concurrent multiple sclerosis and cervical stenosis. Spine J 15(1):18–24.  https://doi.org/10.1016/j.spinee.2014.06.013 CrossRefGoogle Scholar
  2. 2.
    Li J, Zhou DB, Huang Z, Jiao L, Duan MH, Zhang W, Zhao YQ, Shen T (2011) Clinical characteristics and long-term outcome of patients with POEMS syndrome in China. Ann Hematol 90(7):819–826.  https://doi.org/10.1007/s00277-010-1149-0 CrossRefGoogle Scholar
  3. 3.
    Adams D, Said G (1998) Ultrastructural characterisation of the M protein in nerve biopsy of patients with POEMS syndrome. J Neurol Neurosurg Psychiatry 64(6):809–812CrossRefPubMedCentralGoogle Scholar
  4. 4.
    Dispenzieri A, Kyle RA, Lacy MQ, Rajkumar SV, Therneau TM, Larson DR, Greipp PR, Witzig TE, Basu R, Suarez GA, Fonseca R, Lust JA, Gertz MA (2003) POEMS syndrome: definitions and long-term outcome. Blood 101(7):2496–2506.  https://doi.org/10.1182/blood-2002-07-2299 CrossRefGoogle Scholar
  5. 5.
    Gertz MA, Comenzo R, Falk RH, Fermand JP, Hazenberg BP, Hawkins PN, Merlini G, Moreau P, Ronco P, Sanchorawala V, Sezer O, Solomon A, Grateau G (2005) Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): a consensus opinion from the 10th international symposium on amyloid and amyloidosis, Tours, France, 18–22 April 2004. Am J Hematol 79 (4):319–328.  https://doi.org/10.1002/ajh.20381
  6. 6.
    Watanabe O, Arimura K, Kitajima I, Osame M, Maruyama I (1996) Greatly raised vascular endothelial growth factor (VEGF) in POEMS syndrome. Lancet 347(9002):702CrossRefGoogle Scholar
  7. 7.
    Zhang B, Song X, Liang B, Hou Q, Pu S, Ying JR, Gao C (2010) The clinical study of POEMS syndrome in China. Neuro Endocrinol Lett 31(2):229–237Google Scholar
  8. 8.
    Naddaf E, Dispenzieri A, Mandrekar J, Mauermann ML (2016) Clinical spectrum of Castleman disease-associated neuropathy. Neurology 87(23):2457–2462.  https://doi.org/10.1212/wnl.0000000000003405 CrossRefPubMedCentralGoogle Scholar
  9. 9.
    Hu X, Chen Z, Wang Y (2017) A rare case of concomitant cervical disc herniation and intradural meningioma treated with one-stage posterior surgery. Eur Spine J.  https://doi.org/10.1007/s00586-017-5414-y PubMedCentralGoogle Scholar
  10. 10.
    Yu GS, Carson JW (1976) Giant lymph-node hyperplasia, plasma-cell type, of the mediastinum, with peripheral neuropathy. Am J Clin Pathol 66(1):46–53CrossRefGoogle Scholar
  11. 11.
    Klein CJ, Moon JS, Mauermann ML, Zeldenrust SR, Wu Y, Dispenzieri A, Dyck PJ (2011) The neuropathies of Waldenstrom’s macroglobulinemia (WM) and IgM-MGUS. Can J Neurol Sci (Le journal canadien des sciences neurologiques) 38(2):289–295CrossRefGoogle Scholar
  12. 12.
    Mauermann ML (2014) Paraproteinemic neuropathies. Continuum (Minneapolis, Minn) 20(5 Peripheral Nervous System Disorders):1307–1322.  https://doi.org/10.1212/01.con.0000455879.99050.26 Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Tingxian Ling
    • 1
  • Limin Liu
    • 1
  • Yueming Song
    • 1
  • Shilian Zhou
    • 1
  • Chunguang Zhou
    • 1
    Email author
  1. 1.Department of OrthopedicsWest China Hospital of Sichuan UniversityChengduChina

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