A case report of POEMS syndrome developing during the clinical course of immune thrombocytopenic purpura.

Immune thrombocytopenia is commonly seen in patients with lymphoproliferative disorders, but is rare in patients with multiple myeloma. POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes) is defined by the presence of a peripheral neuropathy, a monoclonal plasma cell disorder, and at least one of the following: endocrinopathy, skin changes, osteosclerotic myeloma, Castleman's disease, organomegaly, edema, or papilledema. In this paper, we present a patient with immune thrombocytopenic purpura (ITP) who developed POEMS syndrome during the clinical course of his ITP, and report on the early appearance of an isolated paraneoplastic symptom before the other diagnostic components of POEMS syndrome had developed. To our knowledge, this is the first description of coexistent ITP and POEMS syndrome in the literature.