Uncle Lu is 60 years old this year. Five years ago, he was strong and suddenly began to experience limb numbness and weakness . It started from the ends of both lower limbs and gradually developed to both upper limbs.
At the beginning of the disease, he could still walk normally and his movements were not restricted. Uncle Lu did not take it seriously. His daughter bought various physiotherapy instruments and and a medicine bath prescription for his father, but the symptoms did not improve at all.
In the first half of 2019, Uncle Lu suddenly felt unsteady in . Now he was panicked. His family accompanied Uncle Lu to the Grade A hospital in the province for treatment.
After a series of examinations such as lumbar puncture , electromyography , and other examinations, they were diagnosed as " chronic inflammatory demyelinating polyneuropathy ". They were given hormone, immunoglobulin shock and nutritional nerve treatment, but the symptoms did not slow down.
Therefore, Uncle Lu and his family began a difficult journey of seeking medical treatment. Over the years, they searched for medical treatment, but the results were very little. In addition, the cost of seeing a doctor in recent years was high and the family's financial burden was heavy, so Uncle Lu had to choose to go home to recuperate.
may become more and more serious, and they are unstable in standing and fall frequently. With the recommendation of relatives and friends at home, Uncle Lu came to Yueyang Traditional Chinese Medicine Hospital to seek medical treatment for Director Liu Dan, who has rich experience in diagnosis and treatment of difficult internal medicine diseases.
patients are mentally depressed, malnutrition, obviously thin, dark and rough skin, several swollen lymph nodes can be palpated on both armpits and groin, and the eyes, face and lower limbs are obviously swollen. The muscle strength of both lower limbs is level 4, and the deep feeling disappears.
After detailed medical history inquiry and careful physical examination , Director Liu Dan realized that this case was not that simple: the patient had chronic peripheral neuropathy, and the use of hormone and immunoglobulin shock treatment was ineffective, and the symptoms gradually worsened. This was obviously unexplained with "chronic inflammatory demyelinating polyneuropathy". At the same time, the patient had skin dark, swelling, thin, and lymph nodes . Should we consider a certain type of systemic disease?
Through traditional Chinese medicine, the four diagnosis of combined with to diagnose and diagnose diseases, combined with connective tissue disease , parane tumor syndrome, brain tumor, plasma cell disease and other diseases.
As expected, in plasma cytopathy-related examinations, it was found that monoclonal immunoglobulin M protein existed: immunoglobulin gA quantitative increase, serum immunofixed electrophoresis showed gA entry-type positive.
Now, Director Liu Dan has a preliminary answer in his mind: peripheral neuropathy, lymph node enlargement , M protein , skin pigmentation, the above manifestations all point to a rare type of plasma cell disease - POEMS syndrome .
continued to improve the series of examinations such as bone marrow aspiration . The final examination results confirmed Director Liu Dan's judgment. Uncle Lu was diagnosed with a rare disease, POEMS syndrome.
Five years of long journey to seek medical treatment ushered in the dawn, and Uncle Lu and his family breathed a sigh of relief.
Director Liu Dan chose the hormone + horseflan + thalidomide + Chinese medicine oral Chinese medicine based on the patient's condition and his wishes. After more than 20 days of careful treatment, the patient's symptoms improved significantly, and he was able to walk in the ground and recover and discharge from the hospital.
Director Liu Dan introduced that POEMS syndrome is a multisystem lesion related to plasmacytosis, and is characterized by multiple peripheral neuropathy, enlarged organs, endocrine disorders, M proteinemia and skin lesions.
She reminded that POEMS syndrome is a rare multi-system damage disease in clinical practice. It has diverse clinical manifestations and involves a wide range of organs. It is very easy to misdiagnose and misdiagnose.
For patients with unexplained peripheral neuropathy, it is recommended to screen for the etiology of peripheral neuropathy as soon as possible. For patients with multiple motor sensation of multiple systems, improving serum immunofixed electrophoresis can improve detection rate.
Remember to seek medical treatment in time, early diagnosis and early treatment, so as to bring patients a better prognosis.
(Editor Rainbow. Some pictures are from the Internet, delete if infringement)
Hunan Medical Chat Special Author: Yueyang Traditional Chinese Medicine Hospital Tan Yuan Peng Zhi
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