Is Syphilis a Potential New Factor of the POEMS Syndrome?

A 56‐year‐old man with a 9‐year history of progressive polyneuropathy was admitted to hospital, for feeling worse accompanied with chest discomfort and dyspnea in recent 1 month. In 2005, the patient started complaining of his limbs weakness and numbness then progressed to unable to walk. In 2006, the patient was diagnosed as chronic inflammatory demyelinating polyneuropathy (CIDP) by the local hospital and given methylprednisolone therapy, then long‐term oral course of prednisone and azathioprine. However, the effect was unsatisfied. In 2010, he was referred to our hospital due to worsen symptoms. He reported a history of unclear sexual behavior when he was young. Blood routine test show white blood cell 17 × 109/L, platelet count (PLT) 363 × 109/L, and cerebrospinal fluid (CSF) protein 0.69 g/L were slightly elevated. Thyroid hormones untested. Serum treponema pallidum particle agglutination test positive, other syphilis relative tests such as serum toluidine red unheated serum test, rapid plasma reagin (RPR), Venereal Disease Research Laboratory (VDRL), and CSF RPR, VDRL tests were all negative. Nerve conduction study results demonstrated diffuse and markedly reduced sensory and motor nerve conduction velocities, and prolonged F‐wave responses. Other infectious correlation test such as Epstein–Barr virus, cytomegalovirus, varicella zoster virus, hepatitis B virus, hepatitis C virus, HIV were negative. Antinuclear antibodies, anti‐dsDNA anti‐body etc., showed normal. We