POEMS syndrome: studies in a patient with an IgG-kappa M protein but no polyneuropathy

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Abstract
A 48 yr old woman had a variation of the syndrome of polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes (the so-called POEMS syndrome). The patient''s neurological findings were entirely normal, but she had splenomegaly, hyperprolactinemia with galactorrhea and oligomenorrhea, a thyroid nodule with evidence of mild thyroiditis on aspiration biopsy specimen, an IgG-.kappa. monoclonal gammopathy, and hyperpigmentation and thickening of the skin. A short course of plasmapheresis did not alter any of the clinical abnormalities, but did result in a 70% decrease in the monoclonal IgG level.