Sindrome de Poems
DOI:
https://doi.org/10.31053/1853.0605.v56.n2.40331Palavras-chave:
Síndrome de POEMS asociado con mieloma múltiple.Resumo
El síndrome de P.O.E.M.S. es un raro trastorno multisistémico. Se manifiesta como Pol Inueropatía, Organomegal ía, Endocrinopatía yio Edemas, proteína Monoclonal y cambios en la piel. (Skin changes). P.O.E.M.S.
Aunque alguna bibliografía lo equipara al mieloma osteoesclerático se trata de un verdadero síndrome. La polineruopatía es habitualmente severa. Pese al hallazgo de inmunoglobulinas elevadas en el poems, no se ha aislado un anticuerpo específico que explique la polineuritis si bien es fuertemente sospechado.
La organomegalia, endocrinopatía, cambios en la piel y otros sistemas y órganos involucrados podrían estar en relación a productos secretados por las células plasmáticas. Se revisó la patofisiología y la bibliografía del Poems especialmente en su expresión neurológica y su ubicación nosológica diferente del mieloma oseteosclerótico y una posible relación con el Herpes Virus 8.
Se cruzó en Medline los términos Poems y síndrome y se obtuvieron 271 ahstracts que fueron todos examinados y finalemente seleccionados los que se consideraron signifiativos para los objetivos. Se presenta brevemente un caso.
asociado a las discracias de células plasmáticas, incluido el mieloma osteosclerótico. El pronóstico y el tratamiento varían con
la enfermedad subyacente. Se insinúa como fisiopatología de este síndrome la acción de las interleukinas 1- (IL—1 beta) y 6 (IL- 6), el factor de crecimiento endotelial, el factor de necrosis tumoral alfa (TNF-alfa) y los anticuerpos anti-nervio.
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