Abstract
To show the successful handle of a very rare complication of POEMS syndrome. We report a case of POEMS syndrome wherein the first symptom was recurrent massive pericardial effusions. The patient was misdiagnosed as having tuberculous pericarditis and received anti-tuberculosis treatment for nearly 20 months without effect. She suffered painful pericardiocentesis every 2 to 3 months until the POEMS syndrome diagnosis was confirmed when she appeared with polyneuropathy combined with cervical lymph node biopsy, indicating Castleman disease, serum monoclonal immunoglobulin of IgG λ type, and markedly elevated serum VEGF. Lenalidomide and dexamethasone treatments were introduced, and her pericardial fluid significantly reduced. Massive pericardial effusion is a rare manifestation of POEMS syndrome. POEMS syndromes with polyserositis are easily misdiagnosed as tuberculous polyserous effusions in China. Recognition of the possible pathogenesis of POEMS syndrome with a large amount of pericardial effusion will help to identify POEMS syndrome in an early stage.
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The Peking Union Medical College Training Program funded this study for Young Scholars (2015zlgc0708).
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Informed consent was obtained from the patient for publication of this case report. All procedures followed were in accordance with the ethical standards of PUMCH ethics committee and with the Helsinki Declaration of 1975, as revised in 2008.
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Lin, L., Li, J. & Chen, M. Lenalidomide Treatment for a POEMS Syndrome Patient with Massive Pericardial Effusion as the First Manifestation. SN Compr. Clin. Med. 1, 921–923 (2019). https://doi.org/10.1007/s42399-019-00142-w
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DOI: https://doi.org/10.1007/s42399-019-00142-w