title: Coexistence of the POEMS syndrome with hepatitis B: a rare case report.
abstract: POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) is a rare multisystemic disease of unknown pathogenesis. Proinflammatory and proangiogenic cytokines play important roles in its pathogenesis. POEMS syndrome is a rare cause of ascites. Until now, the coexistence of POEMS syndrome and hepatitis B has not been reported. In this case report, we present a 48-year-old male patient who presented with malaise, fatigue, diarrhea, and abdominal swelling. Organomegaly, endocrinopathy, ascites, skin changes, and polyneuropathy were identified, and we arrived at a diagnosis of POEMS syndrome. The patient was administered methylprednisolone 64 mg/day, lamivudine 100 mg/day, calcium 1.5 g/day, and calcitriol 0.5 µg/day. The patient's clinical manifestations had moderately resolved at the follow-up visits. At the end of 6 months of follow-up, his ascites was minimally reduced, and his neurologic manifestations had not lessened. The present case shows that accurate diagnosis is required for the management of patients with coexisting POEMS syndrome and hepatitis B.
authors.affiliation: Department of Gastroenterology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Yılmaz
authors.initials: Y
authors.lastname: Celik
authors.affiliation: Department of Internal Medicine, Medical Faculty, Yuzuncu Yıl University, Van, Turkey. m.aslan301@mynet.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aslan
authors.affiliation: Department of Neurology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Refah
authors.initials: R
authors.lastname: Sayın
authors.affiliation: Department of Internal Medicine, Medical Faculty, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Cifci
authors.affiliation: Department of Internal Medicine, Medical Faculty, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Esra Turan
authors.initials: ET
authors.lastname: Canbaz
authors.affiliation: Department of Internal Medicine, Medical Faculty, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Kucukoglu
authors.affiliation: Department of Gastroenterology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Ahmet Cumhur
authors.initials: AC
authors.lastname: Dulger
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D019380:Anti-HIV Agents; D007166:Immunosuppressive Agents
keywords: Ascites; Hepatitis B carries; POEMS syndrome; Polyneuropathies