The impact of POEMS syndrome in a medium-sized hospital in Santa Catarina: an experience report

Abstract

POEMS syndrome is an English acronym for the set of symptoms of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes. It corresponds to a paraneoplastic syndrome related to a plasma cell disorder. Thediagnosis is defined by a series of well-established criteria. During a mandatory curricular internship in the neurology service of a hospital in the mountains of Santa Catarina, I observed the challenges that the team faced in establishing the diagnosis of POEMS with a lack of resources in a patient investigated due to disabling chronic polyneuropathy. Even though it was the most likely, there was no diagnostic conclusion. This work seeks to discuss the experience experienced in relation to what is in the literature on the diagnosis of POEMS syndrome. The lack of technical resources, such as measurement of vascular endothelial growth factor (VEGF) elevation, the limited use of available technology, when thinking about imaging investigation methods, or even the clinical presentation being due to another disease that not POEMS are shown as the main sources of the unknown found. Even so, the work generated by the presented situation generated substrate for the development and improvement of clinical and critical reasoning, which in a way will contribute to my academic training and professional life.