Identification of Adrenal Insufficiency Leading to a Diagnosis of POEMS Syndrome

Abstract

A 57-year-old Japanese man with abdominal distention was referred to gastroenterologists at our hospital, where abdominal computed tomography revealed ascites and swollen lymph nodes. He was admitted for testing and treatment. Suffering from unremitting hyponatremia, hyperkalemia, hypotension, and hypoglycemia, he was transferred to our division for electrolyte correction and further diagnosis. Hormone stimulation testing revealed adrenal insufficiency. Upon electrophysiology, immunoelectrophoresis, and measurement of vascular endothelial growth factor, POEMS syndrome was diagnosed. POEMS syndrome may underlie adrenal insufficiency and should be considered when polyneuropathy, ascites, and swollen lymph nodes occur along with adrenal insufficiency.