title: Polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes (POEMS) syndrome refractory to complete serum vascular endothelial growth factor (VEGF) blockade: insights from sequential VEGF monitoring.
abstract: Polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes (POEMS) syndrome is a systemic condition related to plasma cell dyscrasia. Increased vascular permeability is responsible for some of the hallmarks of this disorder that may include renal microangiopathy. Several lines of evidence suggest that vascular endothelial growth factor (VEGF) is central to the pathogenesis of POEMS syndrome. Thus, specifically targeting VEGF over-expression seems to be a promising treatment. Anti-VEGF therapies are yielding conflicting results. We report on a patient with POEMS syndrome treated with bevacizumab, an anti-VEGF monoclonal antibody. Sequential monitoring of serum VEGF showed sustained normalization of serum VEGF levels, without any beneficial effect on the patient's condition. Indications of this treatment should be chosen carefully.
authors.affiliation: Department of Nephrology and Clinical Immunology , University Hospital Rangueil , Toulouse.
authors.forename: Joëlle
authors.initials: J
authors.lastname: Guitard
authors.affiliation: Department of Nephrology and Clinical Immunology , University Hospital Rangueil , Toulouse.
authors.forename: Adèle
authors.initials: A
authors.lastname: Pillet
authors.affiliation: Department of Rheumatology and Clinical Immunology , University Hospital Gabriel Montpied , Clermont-Ferrand.
authors.forename: Martin
authors.initials: M
authors.lastname: Soubrier
authors.affiliation: Department of Histopathology , University Hospital Rangueil.
authors.forename: Anne
authors.initials: A
authors.lastname: Modesto
authors.forename: Dominique
authors.initials: D
authors.lastname: Chauveau
keywords: bevacizumab; microangiopathy; polyneuropathy organomegaly endocrinopathy monoclonal protein; skin changes syndrome; vascular endothelial growth factor