キムラ　シュウヘイ   木村　修平    所属   川崎医科大学  医学部 臨床医学　眼科学１    職種   教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	POEMS syndrome in a 20-year-old patient diagnosed following a complaint of reduced visual acuity.
掲載誌名	正式名：Acta medica Okayama 略　 称：Acta Med Okayama ISSNコード：0386300X/0386300X
掲載区分	国外
巻・号・頁	68(6),pp.379-383
著者・共著者	Doi Shinichiro, Kimura Shuhei, Morizane Yuki, Hosogi Mika, Hosokawa Mio, Shiode Yusuke, Kawata Tetsuhiro, Kondo Eisei, Shiraga Fumio
担当区分	2nd著者
発行年月	2014/12
概要	We report a case of POEMS syndrome in a 20-year-old patient diagnosed after visiting an eye clinic with a chief complaint of reduced visual acuity. A male university student aged 20 years was referred to our department complaining of blurred vision in both eyes that had persisted for 1 month. He also noted headache, nausea, and paresthesia in the lower extremities around the same time. The visual acuity of his right and left eye was 20/40 and 20/20, respectively. Optic disc edema and serous retinal detachment were present. Brain magnetic resonance imaging showed no intracranial abnormalities, while elevated cerebrospinal fluid pressure, reduced nerve conduction velocity in both lower extremities, hepatosplenomegaly, M proteinemia, high blood VEGF levels, osteoblastic and osteolytic changes in the spine, and atypical plasma cells in bone lesions were noted. From the above findings, the patient was diagnosed with POEMS syndrome. He received high-dose dexamethasone, thalidomide, and radiotherapy on the sacral mass, followed by high-dose melphalan with autologous stem-cell support, and showed subsequent systemic and ophthalmologic improvement. Here, we report the youngest case ever of POEMS syndrome with ocular manifestation. If patients have optic disc edema in both eyes with no intracranial space-occupying lesion, POEMS syndrome should be considered in differential diagnosis, regardless of age.
DOI	10.18926/AMO/53028
PMID	25519033