Case 7-2010

Ropper, Allan H.; Raje, Noopur; Lawrimore, Tara M.; Camelo-Piragua, Sandra; Sohani, Aliyah R.

doi:10.1056/nejmcpc0907805

Cited by 13 publications

(2 citation statements)

References 20 publications

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“…VEGF is a potent microvascular permeability-enhancing mediator and a selective mitogen for vascular endothelial cell 8) . Therefore, the VEGF produced by plasma cells leads to a decrease in intravascular volume by increasing vascular permeability, which may contribute to prerenal AKI 5) .…”

Section: Discussionmentioning

confidence: 99%

“…Instead, renal pathology of this patient showed extensive endothelial cell injury and evidence of increased extravascular permeability. Secretion of VEGF from the monoclonal plasma cells in patients with POEMS syndrome has been suspected to trigger these changes 2 5) , but the mechanism remains unknown and must be investigated 6) . In contrast to the pathologic lesions, proteinuria was absent and microscopic hematuria was minimal in this patient, which may reflect a relatively intact glomerular basement membrane structure and podocyte functions.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Rare Case of Polyneuropathy and Monoclonalgammopathy with Recurrent Acute Kidney Injury

Kim

Shin

Jeon

et al. 2016

Electrolyte Blood Press

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POEMS syndrome is a rare paraneoplastic syndrome and there are few reports of polyneuropathy and monoclonal gammopathy associated with kidney dysfunction. Here, we report a case of POEMS syndrome with recurrent acute kidney injury (AKI). A 52-year-old man presented with bilateral aggravating paresthesia and latermotor weakness of the lower extremities accompanied by repeated elevation of serum creatinine. The patient was finally diagnosed with POEMS syndrome on the basis of fulfilling the two mandatory major criteria (polyneuropathy and monoclonal gammopathy), one other major criterion (sclerotic bone lesion), and several minor criteria. A renal biopsy was performed to clarify the cause of AKI and showed membranoproliferative glomerulonephritis-like lesions with mesangiolysis and endothelial cell injury. This case illustrates that renal manifestations, not included in the diagnostic criteria for POEMS, can be apparent before various other systemic symptoms.

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Section: Discussionmentioning

confidence: 99%