Table 2.

Diagnostic Work-up for Suspected POEMS Syndrome (Diagnosis and Relapse)

Diagnostic Work-up for Suspected POEMS Syndrome and at Suspected Relapse
Full blood count with peripheral blood film
Renal and liver panel, electrolytes including calcium
Serum immunoglobulins
Serum (or plasma) VEGF
Routine urinalysis and 24-h urine collection for proteinuria
Testosterone, estradiol, luteinizing hormone, follicle-stimulating hormone, glucose, glycosylated hemoglobin, thyroid profile, prolactin, cortisol, parathyroid hormone; and adrenocorticotrophic hormone
Demonstration of a monoclonal plasma cell disorder
• Serum and urine electrophoresis, immunofixation, and serum-free light chains
• Bone marrow aspirate and trephine biopsy, demonstration of clonal plasma cell infiltration
• Consider bone biopsy from FDG-avid osteosclerotic lesion, demonstrating clonal plasma cells
Nerve conduction studies and EMG
Whole body FDG PET-CT
Electrocardiogram and echocardiogram
Pulmonary function tests

CT = computed tomography; EMG = electromyography; FDG = fluorodeoxyglucose; PET = positron emission tomography; POEMS = Polyneuropathy Organomegaly, Endocrinopathy, M-protein and Skin changes; VEGF = vascular endothelial growth factor.