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Obstetrics and gynaecology
Successful assisted pregnancy outcome in a patient with POEMS syndrome
  1. Abhishek Malakar1,
  2. Shaazma Zainab Naqvi2,
  3. Oliver Tomkins3,
  4. Sukrutha Veerareddy2,
  5. Jonathan Sive3,
  6. Michael Lunn4,
  7. Shirley D’Sa3 and
  8. Oseme Etomi5
  1. 1Obstetrics and Gynaecology, Hull Royal Infirmary, Hull, Yorkshire, UK
  2. 2Obstetrics and Gynaecology, Lewisham and Greenwich NHS Trust, London, London, UK
  3. 3Haematology, University College London Hospitals NHS Foundation Trust, London, London, UK
  4. 4Neuromuscular, University College London Hospitals NHS Foundation Trust, London, London, UK
  5. 5Obstetric Medicine, Lewisham and Greenwich NHS Trust, London, London, UK
  1. Correspondence to Dr Abhishek Malakar; abhishek.malakar{at}nhs.net

Abstract

POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal plasma cell disorder and Skin changes) syndrome is a rare paraneoplastic syndrome caused by a clone of aberrant plasma cells, mostly prevalent in middle-aged men. This is very rare, especially in women of reproductive age group. We are presenting a rare case of POEMS syndrome in pregnancy, who suffered from a full-blown picture of the multisystem involvement of hypothyroidism, hyperprolactinaemia, Empty Sella syndrome leading to panhypopituitarism and benign intracranial hypertension, peripheral neuropathy with trigeminal neuralgia and adrenal insufficiency. She was treated with autologous stem cell transplantation with adjuvant chemotherapy. This case report is a detailed description of the journey from in vitro fertilisation to delivery, the numerous challenges faced and how this was managed with the help of a multidisciplinary involvement to provide optimum perinatal outcome for the patient. Lack of any proper guideline about management of this rare syndrome in pregnancy made this more challenging.

  • Reproductive medicine
  • Pregnancy
  • Endocrinology
  • Haematology (incl blood transfusion)
  • Monoclonal gammopathy of undetermined significance associated neuropathy

https://doi.org/10.1136/bcr-2024-264281

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    Footnotes

    • Contributors The following authors were responsible for drafting the text, sourcing and editing clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: AM, SZN, OT and SV. The following authors gave final approval of the manuscript: AM, SZN, OT, SV, ML, SDS, JS and OE. Guarantor: SV.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.