All‐trans‐retinoic acid in poems syndrome. Therapeutic effect associated with decreased circulating levels of proinflammatory cytokines

Abstract

Chronically elevated serum levels of proinflammatory cytokines is a feature of the syndrome known as POEMS (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal [MI protein, skin changes). A patient had a POEMS syndrome with thrombocytosis and biclonal gammopathy and was treated as follows: all-trans-retinoic acid (tretinoin) at 90 mg/day for 50 days, no treatment for 70 days, readministration of tretinoin at 75 mg/day for 180 days. Focal bone lesion irradiation was performed from day 26 to day 50. Serum levels of interleukin-6 (IL-6), tumor necrosis factor a (TNFa), and IL-lP normalized within 7 days after the first administration of tretinoin, transiently increased at the time of radiotherapy, increased again after withdrawal of the tretinoin, and decreased again after its reintroduction. The platelet count and gammopathy paralleled the changes in the cytokine levels. This study documents in vivo the ability of all-trans-retinoic acid to down-regulate the release of IL-6, IL-lP, and TNFa, and illustrates its potential as a therapeutic agent in conditions associated with chronic overproduction of proinflammatory cytokines.~.

Multiple vascular abnormalities and a paradoxical combination of vitamin B 12 deficiency and thrombocytosis in a case with POEMS syndrome

“…The vertebral signal abnormalities observed in the spinal MRI do not contradict this diagnosis [13]. In addition to several single case reports [1,2,7,8,10,17,19,20,22,23,29], two larger series have demonstrated the high frequency of moderate thrombocytosis in POEMS syndrome [4,24]. Nevertheless, the unique and paradoxical combination of vitamin B 12 deficiency, which is usually associated with thrombocytopenia [9], and thrombocytosis has been reported only once in POEMS syndrome before [28].…”

Thalidomide in POEMS syndrome: Case report

“…In the treatment of the POEMS syndrome cytotoxic agents, corticosteroids, intravenous immunoglobulin, plasma exchange, retinoid acid, and radiation therapy have demonstrated either a modest or no beneficial effect [2,8]. Autologous hematopoietic stem cell transplantation may be a useful treatment option [9].…”

Zidovudine and human immunodeficiency virus-associated peripheral neuropathies: Low intake in patients with mononeuropathy multiplex and no evidence for neurotoxicity

“…The electrophysiological results were analyzed for the patients with DSP, using the diagnostic software tool ''Diagnostica'' (authors: A. Blinowska & A. Wojtasik, Loginserm, copyright Inserm 1992) 1,6 to obtain an objective assessment of the severity of DSP. The parameters analyzed in Diagnostica are: (i) amplitudes and latencies of distal compound muscle action potentials, and conduction velocities of deep peroneal nerves; (ii) amplitudes of distal sensory nerve action potentials, and conduction velocities of sural nerves; and (iii) H indexes calculated as 2 × [height (cm)/H latency − M latency (ms)] 2 .…”