POEMS syndrome caused refractory ascites in a polycystic disease patient undergoing hemodialysis.
A 60-year-old man with polycystic disease (PCD) undergoing hemodialysis was admitted to our hospital because of refractory ascites in September 2000. He had been diagnosed with probable chronic inflammatory demyelinating polyradiculopathy 6 months before admission. Though the ascites was bloody and exudative, the cytology was normal and cultures of bacteria and acid-fast bacillus were both negative. Hepatic venous outflow obstruction was excluded by several radiological examinations. Because of the presence of polyneuropathy, organomegaly, endocrine abnormality, M-protein, plasma cell dyscrasia, and skin lesions, POEMS, syndrome was diagnosed; this had caused the refractory ascites. Initial prednisolone therapy was effective for the refractory ascites, but it was not effective in preventing recurrence. He died due to cachexia in December 2000. This is a very rare case of the presence of both PCD and POEMS syndrome in a patient.
Higuchi
Makoto
M
Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Kamijo
Hiroshi
H
Koyama
Takayuki
T
Kaneko
Yoko
Y
Kamijo
Yuji
Y
Kobayashi
Nobuhiko
N
Shirakawa
Haruaki
H
Hora
Kazuhiko
K
Kiyosawa
Kendo
K
D000906:Antibodies / Q000276:immunology; D001201:Ascites / Q000473:pathology*; D002100:Cachexia / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D007122:Immunoelectrophoresis; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000150:complications / Q000473:pathology* / Q000628:therapy; D007690:Polycystic Kidney Diseases / Q000150:complications / Q000473:pathology* / Q000628:therapy; D012008:Recurrence; D006435:Renal Dialysis
D000906:Antibodies; D007074:Immunoglobulin G