Oncotarget

Case Reports:

Ischemic stroke in patients with POEMS syndrome: a case report and comprehensive analysis of literature

Fang-Wang Fu _, Jie Rao, Yuan-Yuan Zheng, Hui-Lin Wang, Jian-Guang Yang and Guo-Qing Zheng

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Oncotarget. 2017; 8:89406-89424. https://doi.org/10.18632/oncotarget.20131

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Abstract

Fang-Wang Fu1,*, Jie Rao2,*, Yuan-Yuan Zheng1, Hui-Lin Wang1, Jian-Guang Yang1, and Guo-Qing Zheng1

1 Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou city, China

2 Department of Neurology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui City, China

* Co-first author

Correspondence to:

Guo-Qing Zheng, email:

Keywords: POEMS syndrome, ischemic stroke, vasculopathy, vascular endothelial growth factor, vessel wall imaging

Received: March 29, 2017 Accepted: June 28, 2017 Published: August 10, 2017

Abstract

Background: POEMS syndrome is a rare multi-systemic disease characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. Arterial or venous thrombosis is a less-common complication of POEMS syndrome. Ischemic stroke has also been reported sporadically. However, the association between POEMS syndrome and ischemic stroke has not been entirely understood.

Methods: A case of ischemic stroke caused by cerebral vasculitis in a patient with POEMS syndrome was presented. Then a comprehensive review and analysis of the literature were performed.

Results: A total of 28 patients were identified. The common clinical manifestations of POEMS syndrome were rather non-specific in patients with ischemic stroke compared with those of patients without ischemic stroke. Twenty patients were found with multiple ischemic lesions (71.5%). In the 25 patients who had undergone the evaluation of cerebral arteries, nineteen patients (76.0%) were found with cerebral vasculopathy. Twelve patients (48.0%) had more than one cerebral artery involved. Ischemic events were documented in 8 patients even when they were undergoing all the therapy for ischemic stroke. Ten (55.6%) of the 18 patients who had survival data died within two years after stroke events.

Conclusion: Comprehensive analysis of literature revealed several trends in patients with ischemic stroke and POEMS syndrome including a low survival rate and a preponderance of cerebral vasculopathy and multiple cerebral arteries affected. Ischemic stroke may be a poor outcome predictor in patients with POEMS syndrome. Further researches focusing on a larger cohort may help in better characterizing and treating this rare complication of POEMS syndrome.


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