melphalan and Blue-Toe-Syndrome

Arterial and venous thromboses occur in almost one in five patients with POEMS syndrome and usually in macrocirculation.. We report a 67-year-old male with a POEMS syndrome who presented initially with a blue toe syndrome. He complained of Raynaud's syndrome and left foot paresthesia. Physical examination showed gynecomastia, lymphadenopathies and skin lesions. Cardiovascular investigations excluded atrial fibrillation, unstable atherosclerotic lesions and vascular calcifications. Imaging studies showed diffuse osteosclerotic lesions. Monoclonal protein with lambda light chain was discovered and serum level of VEGF was increased at 2900pg/ml.. This is to our knowledge the first case of thrombotic microangiopathy in POEMS syndrome without embolic cause or calciphylaxis.

Topics: Aged; Antineoplastic Agents, Alkylating; Blue Toe Syndrome; Dexamethasone; Glucocorticoids; Humans; Male; Melphalan; POEMS Syndrome; Positron-Emission Tomography; Tomography, X-Ray Computed; Vascular Endothelial Growth Factor A

Topics: Antineoplastic Agents, Alkylating; Blue Toe Syndrome; Catheterization, Peripheral; Humans; Male; Melphalan; Retinal Neoplasms; Retinoblastoma

Topics: Antineoplastic Agents, Alkylating; Blue Toe Syndrome; Catheterization, Peripheral; Humans; Male; Melphalan; Retinal Neoplasms; Retinoblastoma

Topics: Anticoagulants; Antineoplastic Agents, Alkylating; Blue Toe Syndrome; Catheterization, Peripheral; Humans; Infant; Infusions, Intra-Arterial; Male; Melphalan; Retinal Neoplasms; Retinoblastoma; Treatment Outcome