PMID- 12884826
OWN - NLM
STAT- MEDLINE
DCOM- 20031014
LR  - 20181130
IS  - 0009-918X (Print)
IS  - 0009-918X (Linking)
VI  - 43
IP  - 4
DP  - 2003 Apr
TI  - [A case of Crow-Fukase syndrome with extramedullary plasmacytoma: marked clinical 
      deterioration following a biopsy to plasmacytoma].
PG  - 170-5
AB  - A 66-year-old man developed paresthesia of the distal parts of the bilateral 
      lower limbs a week after his upper respiratory infection, followed by the 
      weakness with the legs and paresthesia with the lip area, tongue and finger tips. 
      Those symptoms gradually became worse to the point that he was unable to walk 10 
      days later. Although skin pigmentation, edema, and lymph node swelling were not 
      found, we made a diagnosis of Crow-Fukase syndrome (CFS) because of clinical 
      features of polyneuropathy, IgG-lambda type M proteinemia, endocrinological 
      abnormality, elevated plasma level of vascular endothelial growth factor (VEGF) 
      and extramedullary plasmacytoma in his abdomen. Following intravenous 
      immunoglobulin therapy (IVIg), he showed marked improvement. However, his 
      neurologic symptoms deteriorated acutely just after open biopsy together with the 
      elevation of VEGF level, and a few days later he was in the state of flaccid 
      quadriparesis. We tried IVIg therapy again and his neurologic symptoms were 
      markedly improved. We speculated that an elevated VEGF, released from plasma 
      cells induced by the bioprocedure, might have caused an increase in microvascular 
      permeability and affected the blood-nerve-barrier, thereby his neurologic 
      symptoms deteriorated. It is thought that this case may support the hypothesis 
      that a significant role is played by VEGF in the pathomechanism of the 
      development of CFS. Additionally we experienced that IVIg was very effective to 
      the neurologic symptoms, and we think that IVIg will be able to be one of the 
      future therapy of the CFS. To our knowledge, there has been no report of CFS 
      which manifested acute deterioration of his neurologic symptoms just after open 
      biopsy with acute onset with Guillain-Barre syndrome like symptoms.
FAU - Takakura, Yuka
AU  - Takakura Y
AD  - Department of Neurology, Ohmuta Rosai Hospital, Labour Welfare Corporation.
FAU - Yamaguchi, Yukiko
AU  - Yamaguchi Y
FAU - Miyoshi, Tasuku
AU  - Miyoshi T
LA  - jpn
PT  - Case Reports
PT  - Journal Article
PL  - Japan
TA  - Rinsho Shinkeigaku
JT  - Rinsho shinkeigaku = Clinical neurology
JID - 0417466
RN  - 0 (Biomarkers)
RN  - 0 (Endothelial Growth Factors)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Immunoglobulin lambda-Chains)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Intercellular Signaling Peptides and Proteins)
RN  - 0 (Lymphokines)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - 0 (Vascular Endothelial Growth Factors)
SB  - IM
MH  - Aged
MH  - Biomarkers/blood
MH  - Biopsy/adverse effects
MH  - Capillary Permeability
MH  - Disease Progression
MH  - Endothelial Growth Factors/blood/metabolism/physiology
MH  - Humans
MH  - Immunoglobulin G/blood
MH  - Immunoglobulin lambda-Chains/blood
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Intercellular Signaling Peptides and Proteins/blood/metabolism/physiology
MH  - Lymphokines/blood/metabolism/physiology
MH  - Male
MH  - POEMS Syndrome/diagnosis/*etiology/physiopathology/therapy
MH  - Plasmacytoma/*complications/metabolism
MH  - Vascular Endothelial Growth Factor A
MH  - Vascular Endothelial Growth Factors
EDAT- 2003/07/30 05:00
MHDA- 2003/10/15 05:00
CRDT- 2003/07/30 05:00
PHST- 2003/07/30 05:00 [pubmed]
PHST- 2003/10/15 05:00 [medline]
PHST- 2003/07/30 05:00 [entrez]
PST - ppublish
SO  - Rinsho Shinkeigaku. 2003 Apr;43(4):170-5.