POEMS Syndrome Showing Left Ventricular Dysfunction and Extracellular Edema Assessed by Cardiac Magnetic Resonance Imaging
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...
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| Published in | Internal Medicine Vol. 58; no. 17; pp. 2539 - 2543 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Japan
The Japanese Society of Internal Medicine
01.09.2019
Japan Science and Technology Agency |
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| Abstract | 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. |
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| AbstractList | 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. 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.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. |
| Author | Naya, Masanao Takahashi, Yumi Shimizu, Ai Nakano, Ippei Anzai, Toshihisa Fukushima, Arata Matsuno, Yoshihiro Oyama-Manabe, Noriko Iwano, Hiroyuki |
| Author_xml | – sequence: 1 fullname: Takahashi, Yumi organization: Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan – sequence: 2 fullname: Iwano, Hiroyuki organization: Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan – sequence: 3 fullname: Nakano, Ippei organization: Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan – sequence: 4 fullname: Fukushima, Arata organization: Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan – sequence: 5 fullname: Naya, Masanao organization: Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan – sequence: 6 fullname: Shimizu, Ai organization: Department of Surgical Pathology, Hokkaido University Hospital, Japan – sequence: 7 fullname: Matsuno, Yoshihiro organization: Department of Surgical Pathology, Hokkaido University Hospital, Japan – sequence: 8 fullname: Oyama-Manabe, Noriko organization: Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Japan – sequence: 9 fullname: Anzai, Toshihisa organization: Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31118405$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1111/j.1365-2796.1992.tb00958.x 10.2169/internalmedicine.40.726 10.3324/haematol.2012.073031 10.1536/ihj.38.877 10.2169/internalmedicine.52.9256 10.2169/internalmedicine.49.2833 10.2169/internalmedicine.32.556 10.1016/j.rmed.2014.11.005 10.1111/j.0954-6820.1980.tb01167.x |
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| Keywords | extracellular volume vascular endothelial growth factor POEMS syndrome native T1 mapping |
| Language | English |
| License | The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
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| Notes | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 content type line 14 ObjectType-Report-1 ObjectType-Feature-4 content type line 23 ObjectType-Article-3 Correspondence to Dr. Hiroyuki Iwano, h-iwano@med.hokudai.ac.jp |
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| References | 4. Tanus T, Miller HJ. POEMS syndrome presenting with cardiomegaly and cardiomyopathy. J Intern Med 231: 445-448, 1992. 1. Nozza A. POEMS SYNDROME: an update. Mediterr J Hematol Infect Dis 9: e2017051, 2017. 3. Chandrashekaran S, Dispenzieri A, Cha SS, Kennedy CC. Pulmonary morbidity improves after autologous stem cell transplantation in POEMS syndrome. Respir Med 109: 122-130, 2015. 7. Reitan JB, Pape E, Fossa SD, Julsrud OJ, Slettnes ON, Solheim OP. Osteosclerotic myeloma with polyneuropathy. Acta Med Scand 208: 137-144, 1980. 5. Shimizu N, Goya M, Akimoto H, et al. Cardiomyopathy in a case of Crow-Fukase syndrome. Jpn Heart J 38: 877-880, 1997. 2. Li J, Tian Z, Zheng HY, et al. Pulmonary hypertension in POEMS syndrome. Haematologica 98: 393-398, 2013. 9. Manning WJ, Goldberger AL, Drews RE, et al. POEMS syndrome with myocardial infarction: observations concerning pathogenesis and review of the literature. Semin Arthritis Rheum 22: 151-161, 1992. 6. Ichikawa Y, Nakata T, Ohhata J, et al. Crow-Fukase syndrome with ischemic cardiomyopathy. Intern Med 40: 726-730, 2001. 11. Inoue D, Kato A, Tabata S, et al. Successful treatment of POEMS syndrome complicated by severe congestive heart failure with thalidomide. Intern Med 49: 461-466, 2010. 8. Iwasaki H, Ogawa K, Yoshida H, et al. Crow-Fukase syndrome associated with pulmonary hypertension. Intern Med 32: 556-560, 1993. 10. Yokokawa T, Nakazato K, Kanno Y, et al. Pulmonary hypertension and refractory heart failure in a patient with Crow-Fukase (POEMS) syndrome. Intern Med 52: 1061-1065, 2013. 11 1 2 3 4 5 6 7 8 9 10 |
| References_xml | – reference: 4. Tanus T, Miller HJ. POEMS syndrome presenting with cardiomegaly and cardiomyopathy. J Intern Med 231: 445-448, 1992. – reference: 9. Manning WJ, Goldberger AL, Drews RE, et al. POEMS syndrome with myocardial infarction: observations concerning pathogenesis and review of the literature. Semin Arthritis Rheum 22: 151-161, 1992. – reference: 1. Nozza A. POEMS SYNDROME: an update. Mediterr J Hematol Infect Dis 9: e2017051, 2017. – reference: 2. Li J, Tian Z, Zheng HY, et al. Pulmonary hypertension in POEMS syndrome. Haematologica 98: 393-398, 2013. – reference: 3. Chandrashekaran S, Dispenzieri A, Cha SS, Kennedy CC. Pulmonary morbidity improves after autologous stem cell transplantation in POEMS syndrome. Respir Med 109: 122-130, 2015. – reference: 10. Yokokawa T, Nakazato K, Kanno Y, et al. Pulmonary hypertension and refractory heart failure in a patient with Crow-Fukase (POEMS) syndrome. Intern Med 52: 1061-1065, 2013. – reference: 5. Shimizu N, Goya M, Akimoto H, et al. Cardiomyopathy in a case of Crow-Fukase syndrome. Jpn Heart J 38: 877-880, 1997. – reference: 11. Inoue D, Kato A, Tabata S, et al. Successful treatment of POEMS syndrome complicated by severe congestive heart failure with thalidomide. Intern Med 49: 461-466, 2010. – reference: 6. Ichikawa Y, Nakata T, Ohhata J, et al. Crow-Fukase syndrome with ischemic cardiomyopathy. Intern Med 40: 726-730, 2001. – reference: 7. Reitan JB, Pape E, Fossa SD, Julsrud OJ, Slettnes ON, Solheim OP. Osteosclerotic myeloma with polyneuropathy. Acta Med Scand 208: 137-144, 1980. – reference: 8. Iwasaki H, Ogawa K, Yoshida H, et al. Crow-Fukase syndrome associated with pulmonary hypertension. Intern Med 32: 556-560, 1993. – ident: 4 doi: 10.1111/j.1365-2796.1992.tb00958.x – ident: 6 doi: 10.2169/internalmedicine.40.726 – ident: 2 doi: 10.3324/haematol.2012.073031 – ident: 5 doi: 10.1536/ihj.38.877 – ident: 1 – ident: 10 doi: 10.2169/internalmedicine.52.9256 – ident: 9 – ident: 11 doi: 10.2169/internalmedicine.49.2833 – ident: 8 doi: 10.2169/internalmedicine.32.556 – ident: 3 doi: 10.1016/j.rmed.2014.11.005 – ident: 7 doi: 10.1111/j.0954-6820.1980.tb01167.x |
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| SubjectTerms | 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 |
| Title | POEMS Syndrome Showing Left Ventricular Dysfunction and Extracellular Edema Assessed by Cardiac Magnetic Resonance Imaging |
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