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Multiparameter Flow Cytometry for the Identification of Neoplastic Plasma Cells in POEMS Syndrome with IgG-kappa Gammopathy: Successful Treatment Using Lenalidomide and Dexamethasone.

Authors
  • Ikeda, Sho1
  • Kobayashi, Takahiro1
  • Saito, Masaya1
  • Komatsuda, Atsushi1
  • Ubukawa, Kumi1
  • Kameoka, Yoshihiro1
  • Takahashi, Naoto1
  • 1 Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Japan. , (Japan)
Type
Published Article
Journal
Internal medicine (Tokyo, Japan)
Publication Date
Dec 01, 2019
Volume
58
Issue
23
Pages
3461–3468
Identifiers
DOI: 10.2169/internalmedicine.2882-19
PMID: 31391391
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

A 72-year-old man presented with a 6-month history of systemic edema. Hyperpigmentation, hemangioma, pleural effusion, IgG-kappa-type monoclonal protein, high vascular endothelial growth factor values, renal failure, and nerve conduction study abnormalities were also present. Multiparameter flow cytometry (MFC) showed 0.2% neoplastic plasma cells (CD38-, CD56-, and kappa-positive; CD19-, CD27-, and lambda-negative) in the bone marrow leading to POEMS syndrome. Cases involving kappa-type POEMS syndrome are extremely rare. A kidney biopsy revealed membranous proliferative glomerulonephritis-like changes in our case. Lenalidomide-dexamethasone therapy improved the renal function. Detection of neoplastic plasma cells by MFC was useful for the accurate diagnosis and treatment evaluation.

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