Small fiber neuropathy in patients with chronic graft - versus - host disease after allogeneic hematopoietic stem cell transplantation - preliminary results of a prospective study

Background and purpose: POEMS syndrome (poly­ neuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes) is a rare multisystemic disease, which belongs to plasma cell dyscrasia (monoclonal plasma cell proliferative disorder, almost always λ). Bone fractures in patients with POEMS syndrome are rarely described in literature. They are caused by bone lesions, which can be osteosclerotic, osteolytic with sclerotic shaft or “soap bubble” vision lesions. The aim of this article is to present a rare clinical presentation of POEMS syndrome in a woman with spinal fracture, probably as manifestation of osteosclerotic myeloma. Case report: We have presented a rare clinical case of a female patient with pathological fracture of the thoracic vertebra. Our patient has developed spontaneous asymptomatic vertebral fracture that was initially misdiagnosed as hemangioma, but later histological result has lead us to the possibility of plasmacytoma. Serum protein electrophoresis and immunofixation revealed evidences of monoclonal gammopathy (λ light chains). Conclusions: In patients with chronic and progressive demyelinating polyneuropathy of unknown origin, with systemic manifestation of organs, skin and endocrine glands one should always be thinking of monoclonal plasmacytoma. We report a patient with POEMS syndrome with an extremely rare clinical manifestation. Disclosure: Nothing to disclose PP1248