Overproduction of vascular endothelial growth factor/vascular permeability factor is causative in crow-fukase (POEMS) syndrome

• Published in: Muscle & nerve Vol. 21; no. 11; pp. 1390 - 1397
• Main Authors: Watanabe, Osamu, Maruyama, Ikuro, Arimura, Kimiyoshi, Kitajima, Isao, Arimura, Hitoshi, Hanatani, Mitsuya, Matsuo, Katsuhiko, Arisato, Takayo, Osame, Mitsuhiro
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.11.1998
• Subjects: Adult; Aged; Blotting, Western; Connectin; Crow-Fukase syndrome; cytokine; Endothelial Growth Factors - analysis; Endothelial Growth Factors - blood; Endothelial Growth Factors - chemistry; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulins - analysis; Immunotherapy; isoform; Isomerism; Lymphokines - analysis; Lymphokines - blood; Lymphokines - chemistry; Male; Middle Aged; Molecular Weight; Muscle Proteins - analysis; Muscle Proteins - blood; Myeloma Proteins; POEMS syndrome; POEMS Syndrome - etiology; POEMS Syndrome - metabolism; POEMS Syndrome - therapy; Polyneuropathies - etiology; Polyneuropathies - metabolism; Polyneuropathies - therapy; polyneuropathy; vascular endothelial growth factor; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/(SICI)1097-4598(199811)21:11<1390::AID-MUS5>3.0.CO;2-4

Crow–Fukase or POEMS syndrome of polyneuropathy, organomegaly, endocrinopathy, M‐protein, and skin changes is a rare multisystem disorder of obscure pathogenesis that is associated with microangiopathy, neovascularization, and accelerated vasopermeability. We examined the levels of the vascular endothelial growth factor/vascular permeability factor (VEGF) in the serum and cerebrospinal fluid (CSF) from 10 patients with this syndrome. Serum VEGF levels were about 15–30 times those in control subjects or patients with Guillain–Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and other neurological disorders. The CSF VEGF levels, however, were similar to those found in GBS and CIDP. Elevated VEGF levels in the serum decreased in 7 patients with Crow–Fukase syndrome after conventional therapy. The principal isoform of VEGF in Crow–Fukase syndrome was VEGF165. Elevated VEGF was independent of M‐protein. Our results suggest that the overproduction of VEGF is important in the pathogenesis of this disorder. © 1998 John Wiley & Sons, Inc. Muscle Nerve 21: 1390–1397, 1998