# Secondary Neuropathy From Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Gammopathy, and Skin Changes (POEMS) Syndrome: A Case Report

## TL;DR

A 62-year-old woman with severe nerve damage was diagnosed with POEMS syndrome and showed significant improvement after treatment.

## Contribution

Highlights the importance of considering POEMS syndrome as a secondary cause of polyneuropathy.

## Key findings

- The patient had severe length-dependent neuropathy with demyelination and axonal changes.
- Treatment with lenalidomide, dexamethasone, and stem cell transplant led to marked functional improvement.
- POEMS syndrome was identified as the underlying cause after ruling out other secondary factors.

## Abstract

We report the case of a 62-year-old woman who presented with signs and symptoms of distal sensory polyneuropathy. Her initial electromyography and nerve conduction studies (EMG/NCS) showed a severe length-dependent neuropathy with uniform demyelination and secondary axonal changes. After extensive evaluation for secondary causes, she was ultimately found to have polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. She underwent treatment with lenalidomide and dexamethasone, followed by an autologous stem cell transplant, and is now doing well with marked improvement in her function. This case emphasizes the importance of evaluating for secondary causes of polyneuropathy and provides a brief overview of POEMS syndrome.