Poems syndrome: The rare endocrinopathy

Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic premalignant plasma cell disorder that is characterized by the presence of serum M-protein less than 30 g/L or 3 g/dL, bone marrow (BM) clonal plasma cells less than 10%, absence of plasma cell myeloma (PCM) related end-organ damage (CRAB symptoms: hypercalcemia, renal insufficiency, anemia and, bone lesions) and absence of B-cell lymphoma or other disease known to produce an M-protein. MGUS is generally considered a preneoplastic disorder that does not always progress to overt malignancy (1, 2). Diverse endocrinopathies occur in patients with plasma cell disorders (3-6). One possible scenario is the rather rare POEMS syndrome, which is a paraneoplastic syndrome with key manifestations of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (7). We present a case study which emphasizes the importance of multidisciplinary evaluation of MGUS.