IntroductionRenal involvement in POEMS (polyneuropathy, organomegaly, endocrinopathy, M-band, skin changes) syndrome is considered to be an under-diagnosed phenomenon with no clear treatment path. The limited literature suggests steroids to be the drug of choice, although improvements are limited and usually reverse on withdrawal of the drug.Case presentationA 52-year-old Caucasian woman presenting with features consistent with POEMS syndrome developed progressive renal impairment with proteinuria. Renal biopsy revealed a membranoproliferative glomerulonephritis. She was treated with relatively low dose oral mycophenolate mofetil and prednisolone which stabilised her nephropathy and neuropathy.ConclusionWe describe an alternative therapeutic option in patients with this serious but poorly understood condition.

A young woman of African descent presented with fevers, arthralgia, lymphadenopathy and a skin rash. Modest proteinuria was also noted. The clinical picture suggested an acute HIV sero-conversion illness, and a renal biopsy showed a collapsing glomerulopathy compatible with that diagnosis. However, HIV serology proved persistently negative and a diagnosis of Adult Still's disease was subsequently made (by Yamaguchi criteria). Following steroid treatment, the patient's fever abated and her inflammatory markers returned to normal. Collapsing glomerulopathy is a rare but important complication of Adult Still's disease. Immunosuppressive treatment may be effective in improving renal outcome.