Unusual Types of Plasma Cell Dyscrasias Associated With HIV: Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, and Skin Changes (POEMS) Syndrome

TL;DR

This paper reports a rare case of POEMS syndrome in an HIV patient, highlighting the challenges in diagnosis and successful treatment with lenalidomide.

Contribution

The paper presents a rare case of POEMS syndrome in an HIV patient and demonstrates the effectiveness of lenalidomide therapy.

Findings

POEMS syndrome was misdiagnosed as HIV-related neuropathy before correct identification.

The patient showed significant improvement after six cycles of lenalidomide treatment.

Autologous stem cell transplantation was planned to prevent relapse.

Abstract

Polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome is a multisystem paraneoplastic disorder due to an underlying plasma cell neoplasm, and its occurrence among HIV patients is extremely rare. The diagnosis of POEMS syndrome can be challenging in this context, particularly if its disabling polyneuropathy is misdiagnosed as neuropathy related to HIV. Herein, we report the case of a female patient with treated HIV who later developed POEMS syndrome. After a misdiagnosis of chronic inflammatory demyelinating polyneuropathy related to HIV and unsuccessful corticosteroids and cyclophosphamide therapies, the correct diagnosis of POEMS syndrome was made. The patient achieved significant hematological and neurological improvement after six cycles of lenalidomide. Autologous stem cell transplantation was then scheduled to prevent eventual relapses.

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