title: POEMS syndrome: cryoglobulinemia an unusual association.
abstract: BACKGROUND
  Associations between plasma cell dyscrasia and peripheral neuropathy were well recognized as early as the 1950s. In 1980, Bardwick coined the acronym POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes).
  
  
  OBJECTIVE
  We report a 56-year-old woman who presented with excessive sweating, lethargy, intermittent clawing of fingers and painful limb spasms for 2 years. Clinical examination showed hyperpigmented skin lesions, bilateral pleural effusions and organomegaly. Relevant investigations revealed the presence of sensorimotor polyneuropathy, raised cerebrospinal fluid protein, IgM monoclonal band on serum protein electrophoresis, and reactive bone marrow. The patient was treated with combination therapy which included cyclophosphamide, dexamethasone, and intravenous immunoglobulin with moderate response.
  
  
  CONCLUSIONS
  Presence of cryoglobulinemia in this case has not been described in the literature.
authors.affiliation: Department of Neurology, University College Hospital, Galway, Ireland. mudassir213@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Iqbal
authors.forename: S
authors.initials: S
authors.lastname: Bilal
authors.forename: M
authors.initials: M
authors.lastname: Hennessy
mesh_terms: D003131:Combined Modality Therapy; D003449:Cryoglobulinemia / Q000150:complications*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000150:complications; D008875:Middle Aged; D016878:POEMS Syndrome / Q000150:complications* / Q000628:therapy