POEMS Syndrome Showing Left Ventricular Dysfunction and Extracellular Edema Assessed by Cardiac Magnetic Resonance Imaging

• Published in: Internal Medicine Vol. 58; no. 17; pp. 2539 - 2543
• Main Authors: Takahashi, Yumi, Iwano, Hiroyuki, Nakano, Ippei, Fukushima, Arata, Naya, Masanao, Shimizu, Ai, Matsuno, Yoshihiro, Oyama-Manabe, Noriko, Anzai, Toshihisa
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.09.2019; Japan Science and Technology Agency
• Subjects: Case Report; Cytokines; Cytokines - blood; Dexamethasone - therapeutic use; Drug Therapy, Combination; Edema; Edema - diagnostic imaging; Edema - etiology; Edema - physiopathology; Endocrine disorders; extracellular volume; Female; Glucocorticoids - therapeutic use; Heart; Humans; Internal medicine; Lenalidomide - therapeutic use; M protein; Magnetic Resonance Imaging; Middle Aged; native T1 mapping; NMR; Nuclear magnetic resonance; POEMS syndrome; POEMS Syndrome - blood; POEMS Syndrome - diagnostic imaging; POEMS Syndrome - drug therapy; POEMS Syndrome - physiopathology; Polyneuropathy; Skin; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - blood; Vascular Endothelial Growth Factors - blood; Ventricle; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - drug therapy; Ventricular Dysfunction, Left - physiopathology; extracellular volume; vascular endothelial growth factor; POEMS syndrome; native T1 mapping
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.2842-19

Although cardiac involvement is rare in polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome, the clinical course becomes considerably worse on complication with cardiac lesions. The increased release of various cytokines has been observed in the pathogenesis of POEMS syndrome, and serum vascular endothelial growth factor (VEGF) levels are known to be associated with the disease activity. We herein report a patient with POEMS syndrome who showed left ventricular systolic dysfunction and was treated with lenalidmide therapy. Of note, the reduction in extracellular edema in the left ventricular wall was clearly visualized by changes in the native T1 values and extracellular volumes on cardiac magnetic resonance imaging.