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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
POEMS syndrome is a rare multisystem disorder associated with plasma cell dyscrasia, characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. Early recognition remains challenging, as initial symptoms may be subtle and heterogeneous. We report a case in which characteristic skin findings and bone window computed tomography (CT) provided critical diagnostic clues leading to the early diagnosis of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome.
A woman in her 40s presented with progressive bilateral lower extremity paresthesia (3 years), lower-limb edema (2 years), and Raynaud’s phenomenon with acrocyanosis (1 year). Systemic sclerosis was initially suspected but not confirmed because of the absence of cutaneous sclerosis and a negative autoantibody profile. One month earlier, mild renal insufficiency and proteinuria prompted her referral to our institution. Physical examination revealed marked diffuse skin erythema, hyperpigmentation, hypertrichosis, lower extremity edema, and nail bed pallor. Laboratory tests revealed mild renal impairment (blood urea nitrogen: 12.6 mg/dl, creatinine: 1.21 mg/dl) and proteinuria (1+ on urinalysis, urine protein-to-creatinine ratio: 0.1 g/gCr). Chest radiography demonstrated cardiomegaly with pleural effusion, and echocardiography demonstrated pulmonary hypertension (estimated pulmonary arterial pressure, 32 mm Hg). Based on these clinical findings, POEMS syndrome was suspected. Switching to bone window setting on CT revealed multiple osteosclerotic lesions, leading to a prompt diagnosis.
Further evaluation revealed markedly elevated serum vascular endothelial growth factor (6274 pg/ml), positive urine Bence Jones protein (λ-type), demyelinating peripheral polyneuropathy on nerve conduction studies, and bilateral papilledema on fundoscopic examination. The bone marrow biopsy showed plasma cell infiltration of <10%. The patient was diagnosed with POEMS syndrome.
This case underscores the importance of multidisciplinary evaluation, including dermatologic and radiologic perspectives, in identifying early manifestations of POEMS syndrome. Bone window CT serves as a powerful adjunct to conventional imaging in detecting osteosclerotic lesions that may otherwise be overlooked. Early recognition and appropriate imaging can help preserve kidney function and improve overall outcomes in systemic diseases such as POEMS syndrome.
This case has been published as a Clinical Image in Kidney International (Yoshihara M, et al. 2025; Early diagnosis of POEMS syndrome prompted by skin findings and bone window computed tomography).
