title: POEMS syndrome--a case for more aggressive treatment.
abstract: BACKGROUND
  Patients with POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal or M-protein and skin changes) syndrome exhibit a wide range of clinical manifestations and are often seen by a variety of specialists prior to diagnosis.
  
  
  METHODS
  We describe a case of POEMS syndrome that first presented with significant neuropathy but progressed to develop further manifestations of the condition, including marked gastrointestinal symptoms.
  
  
  METHODS
  The patient was commenced on localised radiotherapy and chemotherapy in addition to immunomodulatory therapy for the neuropathy.
  
  
  CONCLUSIONS
  We highlight several learning points that may benefit physicians from varied specialties. This case is also unique for its marked gastrointestinal manifestation. To our knowledge, this is the second reported case in the literature with this feature.
authors.affiliation: Department of Medicine, Division of Neurology, National University Hospital, Singapore. rahulrathakrishnan@yahoo.com.sg
authors.forename: Rahul
authors.initials: R
authors.lastname: Rathakrishnan
authors.forename: Te-Chih
authors.initials: TC
authors.lastname: Liu
authors.forename: Yee-Cheun
authors.initials: YC
authors.lastname: Chan
authors.forename: Benjamin K C
authors.initials: BK
authors.lastname: Ong
mesh_terms: D005767:Gastrointestinal Diseases / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors