Overproduction of vascular endothelial growth factor/vascular permeability factor is causative in Crow-Fukase (POEMS) syndrome.
Crow-Fukase or POEMS syndrome of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes is a rare multisystem disorder of obscure pathogenesis that is associated with microangiopathy, neovascularization, and accelerated vasopermeability. We examined the levels of the vascular endothelial growth factor/vascular permeability factor (VEGF) in the serum and cerebrospinal fluid (CSF) from 10 patients with this syndrome. Serum VEGF levels were about 15-30 times those in control subjects or patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and other neurological disorders. The CSF VEGF levels, however, were similar to those found in GBS and CIDP. Elevated VEGF levels in the serum decreased in 7 patients with Crow-Fukase syndrome after conventional therapy. The principal isoform of VEGF in Crow-Fukase syndrome was VEGF165. Elevated VEGF was independent of M-protein. Our results suggest that the overproduction of VEGF is important in the pathogenesis of this disorder.
The Third Department of Internal Medicine, Kagoshima University, School of Medicine, Japan.
O
O
Watanabe
I
I
Maruyama
K
K
Arimura
I
I
Kitajima
H
H
Arimura
M
M
Hanatani
K
K
Matsuo
T
T
Arisato
M
M
Osame
D000328:Adult; D000368:Aged; D015153:Blotting, Western; D064211:Connectin; D016228:Endothelial Growth Factors / Q000032:analysis / Q000097:blood* / Q000737:chemistry; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D007167:Immunotherapy; D007536:Isomerism; D008222:Lymphokines / Q000032:analysis / Q000097:blood* / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D009124:Muscle Proteins / Q000032:analysis / Q000097:blood; D009194:Myeloma Proteins; D016878:POEMS Syndrome / Q000209:etiology* / Q000378:metabolism* / Q000628:therapy; D011115:Polyneuropathies / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D064211:Connectin; D016228:Endothelial Growth Factors; D007136:Immunoglobulins; D008222:Lymphokines; D009124:Muscle Proteins; D009194:Myeloma Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; C085016:multiple myeloma M-proteins