Pulmonary Hypertension and Refractory Heart Failure in a Patient with Crow-Fukase (POEMS) Syndrome

Tetsuro Yokokawa; Kazuhiko Nakazato; Yuki Kanno; Hiroyuki Mizukami; Atsushi Kobayashi; Akiomi Yoshihisa; Hiroshi Takahashi; Akiko Shichishima-Nakamura; Hiroshi Ohkawara; Hideyoshi Noji; Hitoshi Suzuki; Shu-ichi Saitoh; Kazuei Ogawa; Shinichi Hisa; Yasuchika Takeishi

doi:10.2169/internalmedicine.52.9256

CASE REPORTS

Pulmonary Hypertension and Refractory Heart Failure in a Patient with Crow-Fukase (POEMS) Syndrome

Tetsuro Yokokawa, Kazuhiko Nakazato, Yuki Kanno, Hiroyuki Mizukami, Atsushi Kobayashi, Akiomi Yoshihisa, Hiroshi Takahashi, Akiko Shichishima-Nakamura, Hiroshi Ohkawara, Hideyoshi Noji, Hitoshi Suzuki, Shu-ichi Saitoh, Kazuei Ogawa, Shinichi Hisa, Yasuchika Takeishi

Author information

Tetsuro Yokokawa
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Kazuhiko Nakazato
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Yuki Kanno
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Hiroyuki Mizukami
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Atsushi Kobayashi
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Akiomi Yoshihisa
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Hiroshi Takahashi
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Akiko Shichishima-Nakamura
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Hiroshi Ohkawara
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Hideyoshi Noji
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Hitoshi Suzuki
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Shu-ichi Saitoh
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Kazuei Ogawa
Department of Cardiology and Hematology, Fukushima Medical University, Japan
Shinichi Hisa
Masu Memorial Hospital, Japan
Yasuchika Takeishi
Department of Cardiology and Hematology, Fukushima Medical University, Japan

Keywords: pulmonary hypertension, Crow-Fukase (POEMS) syndrome, heart failure, vascular endothelial growth factor (VEGF), diastolic dysfunction, sleep-disordered breathing

JOURNAL OPEN ACCESS

2013 Volume 52 Issue 10 Pages 1061-1065

DOI https://doi.org/10.2169/internalmedicine.52.9256

Details

Abstract

We experienced the case of a 67-year-old man with refractory heart failure. He presented with dyspnea and progressive pitting edema of the lower limbs. Diuretics were insufficient to improve his symptoms. Cardiac catheterization demonstrated pulmonary hypertension. Additional examinations confirmed polyneuropathy, organomegaly, endocrinopathy and monoclonal gammopathy. The plasma vascular endothelial growth factor (VEGF) level was 1,340 pg/mL. The patient was diagnosed with Crow-Fukase (POEMS) syndrome. Echocardiography detected left ventricular hypertrophy and diastolic dysfunction. Polysomnography demonstrated severe sleep-disordered breathing. We herein describe a case of pulmonary hypertension with Crow-Fukase syndrome accompanied by left ventricular diastolic dysfunction and sleep-disordered breathing.

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