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Cancers 2017, 9(10), 129; doi:10.3390/cancers9100129

Alcohol Misuse Link to POEMS Syndrome in a Patient

1
Department of Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada
2
Juravinski Hospital, Hamilton, ON L8N 3Z5, Canada
3
Division of Gastroenterology, Sunnybrook Health Sciences Centre and Department of Internal Medicine, University of Toronto, Toronto, ON M4N 3M5, Canada
4
In Vitro Drug Safety and Biotechnology, Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5G 1L5, Canada
*
Author to whom correspondence should be addressed.
Academic Editors: Helmut K. Seitz and Sebastian Mueller
Received: 4 September 2017 / Revised: 15 September 2017 / Accepted: 19 September 2017 / Published: 23 September 2017
(This article belongs to the Special Issue Alcohol and Cancer)
View Full-Text   |   Download PDF [470 KB, uploaded 23 September 2017]   |  

Abstract

Previously called Crow–Fukase syndrome, POEMS syndrome is characterized by poly-neuropathy, osteo-sclerotic myeloma, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes. Extremely elevated levels of serum vascular endothelial growth factor (VEGF) are characteristic of the syndrome. Chronic hepatitis B (HBV) and C (HCV) infections can also be present in POEMS. The pathogenesis of the syndrome is not well understood. The link between chronic alcohol consumption and this malignant condition has not been reported until now. In addition, no previous study has evaluated the influence of cytokine and chemokines or viruses in the severity and evolution of POEMS. Objectives: (1) to describe a heavy-alcohol user, who was diagnosed with POEMS; (2) to demonstrate the utility of quantitative measurement of serum levels of VEGF in the diagnosis of POEMS and the monitoring of therapeutic interventions; (3) to demonstrate that overproduction of pro-inflammatory cytokines is a characteristic of POEMS. Methods: We describe a case of a POEMS patient presenting HCV and who is a heavy drinker; we compare the serum levels of cytokines and chemokines between the POEMS patient with 80 patients with HCV, 12 healthy controls, and 80 individuals with alcoholic liver disease (ALD). We quantified (ELISA pg/mL) the levels of VEGF, Interferon gamma (IFN-γ), Tumor Necrosis Factor alpha (TNF-α), Regulated-upon-Activation Normal-T-cell-Expressed and presumably-Secreted (RANTES), and Nuclear Factor kappa-B (NFκB). Results: In POEMS patients, VEGF levels were elevated versus control or other diseases, TNFα levels were higher versus control, but lower when compared with HCV or ALD patients. VEGF levels in POEMS patients decreased with therapeutic intervention. Conclusions: Chronic alcohol misuse can be a strong risk factor to rare malignancies such as POEMS syndrome. Extreme elevation of VEGF levels is diagnostic for POEMS syndrome, and should be followed to assess response to therapy. In addition, other comorbidities should be considered individually to ensure personalized therapeutic intervention. View Full-Text
Keywords: alcohol; malignancy; POEMS; biomarkers; VEGF; TNF-alpha; RANTES alcohol; malignancy; POEMS; biomarkers; VEGF; TNF-alpha; RANTES
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Neary, J.; Goodwin, S.E.; Cohen, L.B.; Neuman, M.G. Alcohol Misuse Link to POEMS Syndrome in a Patient. Cancers 2017, 9, 129.

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