Author/Authors :
Ashrafi، Farzaneh نويسنده , , Darakhshandeh، Ali نويسنده Resident, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran , , Nematolahy، Pardis نويسنده Pathologist, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran , , KHOSRAVI، ALIREZA نويسنده ,
Abstract :
BACKGROUND: Polyneuropathy, organomegaly, endocrinopathy, monoclonal syndrome
(POEMS) is a rare paraneoplastic syndrome associated with plasma cell dyscrasia.
CASE REPORT: A 48-year-old man presented with a 1-year history of paresthesia and
progressive weakness of extremities. Diagnosis of POEMS syndrome was made for him on the
basis of clinical presentation, additional physical findings, typical sclerotic bone lesion, and
bone marrow findings. In last admission, he explained episodes of dyspnea and chest pain that
associated with frequent premature ventricular contraction in his electrocardiograph. Patient
heart monitoring showed some episodes of complete heart block. Infra-His atrioventricular
block in electro-physiologic study was detected. He had no history of ischemic heart disease. His
cardiopulmonary findings on examination were normal. All results of cardiac biomarkers and
serum electrolytes and repeated echocardiography were within normal range. Cong red staining
of rectal fat pad biopsy was negative. After pacemaker insertion radiation of sclerotic bone,
lesion started for him, but radiotherapy was ineffective, and he expired with respiratory failure.
Complete heart block in POEMS syndrome has not been reported previously, and it is the first
POEMS case with complete heart block.
CONCLUSION: Complete heart block is a cardiac manifestation of POEMS syndrome.
