title: POEMS syndrome with vascular lesions: a role for interleukin-1beta and interleukin-6 increase--a case report.
abstract: The authors describe the case of a 60-year-old man with POEMS syndrome associated with vascular lesions. The patient had osteosclerotic myeloma IgA (lambda), polyneuropathy, endocrinopathy, and skin changes. Subsequently, he developed gangrene of the lower limbs with no response to heparin therapy. The humoral study showed thrombocythemia, high levels of interleukin-1beta (IL-1beta) and IL-6 and of some coagulative/fibrinolytic and endothelial factors (von Willebrand factor, plasmin-antiplasmin complexes, plasminogen activator, and endothelial adhesion molecule ICAM-1). The authors suggest that these factors, induced by the increased levels of cytokines, could be responsible for microvascular damage, gangrene, and heparin resistance.
authors.affiliation: Department of Clinical Immunology, Atherosclerosis Research Center, University of Siena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bova
authors.forename: A L
authors.initials: AL
authors.lastname: Pasqui
authors.forename: M
authors.initials: M
authors.lastname: Saletti
authors.forename: F
authors.initials: F
authors.lastname: Bruni
authors.forename: A
authors.initials: A
authors.lastname: Auteri
mesh_terms: D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005734:Gangrene / Q000188:drug therapy; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007375:Interleukin-1 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D014652:Vascular Diseases / Q000097:blood / Q000150:complications* / Q000503:physiopathology*
chemical_list: D005343:Fibrinolytic Agents; D007375:Interleukin-1; D015850:Interleukin-6; D006493:Heparin