Pulmonary hypertension and refractory heart failure in a patient with Crow-Fukase (POEMS) syndrome

Intern Med. 2013;52(10):1061-5. doi: 10.2169/internalmedicine.52.9256. Epub 2013 May 15.

Abstract

We experienced the case of a 67-year-old man with refractory heart failure. He presented with dyspnea and progressive pitting edema of the lower limbs. Diuretics were insufficient to improve his symptoms. Cardiac catheterization demonstrated pulmonary hypertension. Additional examinations confirmed polyneuropathy, organomegaly, endocrinopathy and monoclonal gammopathy. The plasma vascular endothelial growth factor (VEGF) level was 1,340 pg/mL. The patient was diagnosed with Crow-Fukase (POEMS) syndrome. Echocardiography detected left ventricular hypertrophy and diastolic dysfunction. Polysomnography demonstrated severe sleep-disordered breathing. We herein describe a case of pulmonary hypertension with Crow-Fukase syndrome accompanied by left ventricular diastolic dysfunction and sleep-disordered breathing.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use
  • Diuretics / therapeutic use
  • Drug Resistance
  • Edema / etiology
  • Furosemide / therapeutic use
  • Heart Failure / etiology*
  • Humans
  • Hypertension, Pulmonary / etiology*
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / etiology
  • Male
  • Melphalan / administration & dosage
  • Melphalan / therapeutic use
  • POEMS Syndrome / blood
  • POEMS Syndrome / complications*
  • POEMS Syndrome / diagnosis
  • POEMS Syndrome / drug therapy
  • Polysomnography
  • Prednisolone / administration & dosage
  • Prednisolone / therapeutic use
  • Pulmonary Wedge Pressure
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / etiology
  • Thalidomide / administration & dosage
  • Thalidomide / therapeutic use
  • Ultrasonography
  • Vascular Endothelial Growth Factor A / blood
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology

Substances

  • Diuretics
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Thalidomide
  • Furosemide
  • Dexamethasone
  • Prednisolone
  • Melphalan