Brazilian Journal of Health Review ISSN: 2595-6825 2585 Brazilian Journal of Health Review, Curitiba, v.5, n.1, p. 2585-2587 jan./feb. 2022 POEMS Syndrome: a clinical challenge Síndrome de POEMS: um desafio clínico DOI:10.34119/bjhrv5n1-232 Recebimento dos originais: 03/01/2022 Aceitação para publicação: 10/02/2022 Vanessa de Sousa Brito Neurologista Hospital Beneficência Portuguesa de São Paulo R. Maestro Cardim, 769 - Bela Vista, São Paulo - SP, 01323-001 E-mail: vanessasousabrito@gmail.com Fernando Freua Neurologista Hospital Beneficência Portuguesa de São Paulo R. Maestro Cardim, 769 - Bela Vista, São Paulo - SP, 01323-0 E-mail: fernando.freua@hc.fm.usp.br Christian Henrique de Andrade Freitas Neurologista Hospital Beneficência Portuguesa de São Paulo R. Maestro Cardim, 769 - Bela Vista, São Paulo - SP, 01323-0 E-mail: chafreitas45@gmail.com ABSTRACT A 42-year-old male patient admitted to our service with a history of progressive and symmetrical weakness, paresthesia of the lower limbs, weight loss and urinary retention for about 8 months. Physical examination demonstrated poor general condition, lower limb edema, hepatomegaly and digital clubbing. Neurological examination showed a polyneuropathic pattern, with hypoesthesia and absence of deep reflexes of the lower limbs. Initial laboratory investigation demonstrated erythrocytosis and thyroid and adrenal dysfunction in addition to hypergammaglobulinemia. CSF analysis, due to the clinical suspicion of chronic inflammatory demyelinating polyneuropathy, resulted in protein-cytological dissociation. PIDC was hypothesized to be due to light-chain disease, but for this association we supplemented with bone marrow analysis and whole-body CT scan, which showed 4% atypia in plasma cells and osteolytic and osteoblastic lesions in the vertebro-costal region between the 8th and 9th vertebrae. Subsequent biopsy confirmed plasmacytoma. He performed autologous bone marrow transplantation, but evolved with infectious complications and died within 3 months. KEYWORD: POEMS syndrome, chronic inflammatory demyelinating polyneuropathy, hypergammaglobulinemia RESUMO Paciente masculino de 42 anos admitido no nosso serviço com história de fraqueza progressiva e simétrica, parestesia dos membros inferiores, perda de peso e retenção urinária por cerca de 8 meses. O exame físico demonstrou mau estado geral, edema de membros inferiores, hepatomegalia e baqueteamento digital. Ao exame neurológico apresentava padrão