melphalan and Sleep-Apnea-Syndromes

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.

Topics: Aged; Dexamethasone; Diuretics; Drug Resistance; Edema; Furosemide; Heart Failure; Humans; Hypertension, Pulmonary; Hypertrophy, Left Ventricular; Male; Melphalan; POEMS Syndrome; Polysomnography; Prednisolone; Pulmonary Wedge Pressure; Sleep Apnea Syndromes; Thalidomide; Ultrasonography; Vascular Endothelial Growth Factor A; Ventricular Dysfunction, Left