POEMS syndrome physical examination: Difference between revisions
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===Appearance=== | ===Appearance=== | ||
* [[Anasarca]] or [[ascites]] may be present. | * [[Anasarca]] or [[ascites]] may be present. | ||
===CNS=== | |||
*Decreased muscle strength<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | |||
*Absent deep tendon reflexes<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | |||
*Impaired temperature, position, and vibration senses<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | |||
===Skin=== | ===Skin=== | ||
* [[Hyperpigmentation]] | * [[Hyperpigmentation]] | ||
* [[Nail clubbing]] | * [[Nail clubbing]] | ||
* [[Leuconychia]] | * [[Leuconychia]] | ||
* Thickening of the skin | * Thickening of the skin<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | ||
* Excess hair or hair in unusual places ([[hypertrichosis]]) | * Excess hair or hair in unusual places ([[hypertrichosis]]) | ||
* Skin [[angioma]]s or [[haemangioma]]s | * Skin [[angioma]]s or [[haemangioma]]s<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | ||
* There may be changes reminiscent of [[scleroderma]] | * There may be changes reminiscent of [[scleroderma]] | ||
| Line 24: | Line 28: | ||
=== Neurological === | === Neurological === | ||
* Symmetrical, ascending chronic progressive [[polyneuropathy]] with both [[Sensory system|sensory]] (pin-prick and vibration) and motor disability (motor > sensory) | * Symmetrical, ascending chronic progressive [[polyneuropathy]] with both [[Sensory system|sensory]] (pin-prick and vibration) and motor disability (motor > sensory) | ||
* | *Decreased muscle strength<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | ||
*Absent deep tendon reflexes<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | |||
*Impaired temperature, position, and vibration senses<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | |||
===Abdomen=== | ===Abdomen=== | ||
Revision as of 06:03, 8 February 2019
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POEMS syndrome Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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POEMS syndrome physical examination On the Web |
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American Roentgen Ray Society Images of POEMS syndrome physical examination |
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Risk calculators and risk factors for POEMS syndrome physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Common physical examination findings of POEMS syndrome include, organomegaly (hepatomegaly, splenomegaly), peripheral edema/anasarca, ascites, mixed lytic/sclerotic bone lesions, papilledema, skin hyperpigmentation and lymphadenopathy.
Physical Examination
Appearance
CNS
- Decreased muscle strength[1]
- Absent deep tendon reflexes[1]
- Impaired temperature, position, and vibration senses[1]
Skin
- Hyperpigmentation
- Nail clubbing
- Leuconychia
- Thickening of the skin[1]
- Excess hair or hair in unusual places (hypertrichosis)
- Skin angiomas or haemangiomas[1]
- There may be changes reminiscent of scleroderma
Eye
- Papilledema
- Uveitis and preretinal haemorrhage may be present.
Neurological
- Symmetrical, ascending chronic progressive polyneuropathy with both sensory (pin-prick and vibration) and motor disability (motor > sensory)
- Decreased muscle strength[1]
- Absent deep tendon reflexes[1]
- Impaired temperature, position, and vibration senses[1]
Abdomen
- Hepatomegaly
- Splenomegaly
- Ascites (succession splash, shifting dullness)
Cardiovascular
Respiratory
- Pleural effusion (decreased or absent breath sounds, decreased tactile fremitus, dullness to percussion)
Musculoskeletal
- Bones may have sclerotic, lytic with sclerotic rims or mixed sclerotic/lytic lesions with soup-bubble appearance