POEMS syndrome: an uncommon cause of peritoneal effusion

A 46-year-old female patient was admitted to our hospital with abdominal distension and fatigue for 1 months. Physical examination revealed several lymph nodes were palpable in bilateral axilla and groin, ranging from 0.5cm to 2.0cm in diameter, with tolerable mobility and no obvious tenderness. Computed tomography (CT) indicated splenomegaly, abdominal effusions, and multiple lymph nodes were enlarged. To further confirm the diagnosis, the patient underwent a transjugular liver biopsy, and the pathology ruled out cirrhosis. With the progress of the disease, the patient began to appear facial erythema, generalised hyperpigmentation, and both lower limbs numbness. Then the patient underwent a cervical lymph node biopsy and the pathology was consistent with Castleman disease. In addition, immunofixation electrophoresis suggested IgA-λ monoclonal protein. The electromyography test confirmed the hampered nerve conduction velocity of peroneal, tibial, and sural nerves. The clinical presentations and investigations suggested POEMS syndrome.