Recurrent POEMS Syndrome Presenting with Diarrhea as the Dominant Symptom: A Case Report

POEMS综合征是一种罕见的单克隆浆细胞疾病，其临床特征为多发性神经病、脏器肿大、内分泌病变、单克隆免疫球蛋白血症以及皮肤改变。腹泻症状在POEMS综合征中并不常见。我们报告了一例以腹泻为主要表现的复发性POEMS综合征患者的病例。该患者接受了多次胃镜检查和息肉切除术，但症状并未改善。随后的免疫固定电泳显示存在IgA-λ型M蛋白条带，且血管内皮生长因子升高，提示可能存在POEMS综合征复发。腹泻作为POEMS综合征罕见且不典型的症状，给POEMS综合征复发的诊断带来了重大挑战。全面评估和管理对于POEMS综合征及早诊断及改善预后具有重要作用。POEMS syndrome is a rare monoclonal plasma cell disorder characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. Diarrhea is an uncommon manifestation in POEMS syndrome. We report a case of recurrent POEMS syndrome presenting predominantly with diarrhea. The patient underwent multiple gastroscopies and polypectomies without symptomatic improvement. Subsequent immunofixation electrophoresis revealed an IgA-λ monoclonal protein band, and elevated vascular endothelial growth factor (VEGF) levels suggested potential disease recurrence. Diarrhea, as a rare and atypical symptom of POEMS syndrome, posed significant diagnostic challenges in identifying disease relapse. Comprehensive evaluation and management are critical for early diagnosis and improving prognosis in POEMS syndrome.