POEMS Syndrome: Complete Guide to Symptoms, Causes, and Treatment
Updated: 1 hour ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
POEMS syndrome is a rare blood disorder that damages nerves and affects other parts of the body. Its name is an acronym made from its symptoms: polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes. Every person with POEMS syndrome has both polyneuropathy and monoclonal protein. The condition worsens quickly without treatment and can be life-threatening, but treatments such as radiation therapy, chemotherapy, and stem cell transplant may improve symptoms, and the outlook has improved greatly over the years.
POEMS syndrome is a rare blood disorder that damages nerves and affects other parts of the body. POEMS stands for the symptoms of the condition: polyneuropathy, organomegaly, endocrinopathy and edema, monoclonal protein, and skin changes. Symptoms most often appear over weeks to months. Everyone with POEMS syndrome has polyneuropathy and monoclonal protein. There is no cure, but treatment — which may include radiation therapy, chemotherapy, and stem cell transplant — might improve symptoms.
What Is POEMS Syndrome?
POEMS syndrome is a rare blood disorder that damages nerves and affects other parts of the body. POEMS stands for symptoms of the condition. Symptoms may include weak legs, trouble breathing, a larger spleen or liver, and skin changes.
Without treatment, POEMS syndrome gets worse quickly. It can become life-threatening. So early diagnosis is vital.
The symptoms of POEMS syndrome most often appear over weeks to months. Not all the symptoms of POEMS syndrome are in the name. And not everyone with POEMS syndrome has all the symptoms in the name. But everyone with POEMS syndrome has polyneuropathy and monoclonal protein.
What Are the Symptoms of POEMS Syndrome?
The symptoms of POEMS syndrome make up its name. They include the following:
Symptom | What It Means |
P — Polyneuropathy | This may include numbness, tingling and weakness in the legs. In time, it might affect the hands. It also involves trouble breathing. Polyneuropathy must be present for a POEMS diagnosis. |
O — Organomegaly | This is an enlarged spleen, liver or lymph nodes. |
E — Endocrinopathy and edema | Atypical hormone levels can cause an underactive thyroid, also called hypothyroidism. The hormone levels also can cause diabetes, sexual issues, tiredness, and swelling in arms and legs. |
M — Monoclonal protein | This is a protein that atypical plasma cells in bone marrow make. The monoclonal protein goes into the bloodstream. This must be present for the diagnosis of POEMS syndrome. Monoclonal protein often is linked with bones getting harder or thicker. |
S — Skin changes | This may involve having more color than usual on the skin. There may be red spots, which may be harder to see on Black or brown skin. The skin might be thicker. There might be more hair on the face or the legs. |
What Other Symptoms Can Occur?
Other symptoms some people with POEMS syndrome have spell out PEST.
Symptom | What It Means |
P — Papilledema | This is swelling in the back of the eyes. |
E — Extravascular volume overload | This might include ankle swelling, fluid between the lung and the ribs, or fluid in the belly. |
S — Sclerotic bone lesions | X-rays can show these bone spots. They're most often not painful. |
T — Thrombocytosis and erythrocytosis | These are higher levels of red cells and platelets in the bloodstream. |
What Causes POEMS Syndrome?
Experts don't know the cause of POEMS syndrome. But people with POEMS syndrome have a higher number of plasma cells. These cells make too much of a type of protein, called monoclonal protein. This protein can damage other parts of the body.
What Are the Risk Factors?
Factors that raise the risk of POEMS syndrome include older age and male sex.
Risk Factor | Details |
Older age | POEMS syndrome most often happens after age 50. |
Male sex | People assigned male at birth are a bit more likely to get POEMS syndrome than are people assigned female at birth. |
When Should You See a Doctor?
Make an appointment with your healthcare professional if you have any of the symptoms of POEMS syndrome. Because POEMS syndrome gets worse quickly without treatment and can become life-threatening, early diagnosis is vital.
How Is POEMS Syndrome Diagnosed?
A healthcare professional takes a medical history and does a physical exam to diagnose POEMS syndrome, along with a neurological exam to check the nervous system. POEMS syndrome can be hard to diagnose because the symptoms are complex, and they affect many organs.
There might be several tests for POEMS syndrome:
Test | What It Shows |
Electromyographic studies (EMG) | Measures the electrical activity of muscles using small needle electrodes placed in the skin, at rest and when tightened. This can show how well the muscle and the nerves that control it work. |
Nerve biopsy | A healthcare professional removes a small piece of nerve for study under a microscope. |
Imaging tests | These might include CT scans or PET scans, which can help find the bone hardening that is common in POEMS syndrome. |
Blood tests | A complete blood count (CBC) or a peripheral blood smear can give information about your condition. |
Urine tests | A healthcare professional may ask you to collect your urine for 24 hours for study under a microscope. |
How Is POEMS Syndrome Treated?
Treatment for POEMS syndrome might ease symptoms but doesn't cure the condition. Treatments include radiation therapy, chemotherapy and stem cell transplant. The outlook for people with POEMS syndrome has improved greatly over the past decade or so.
Treatment | How It Works | Who It's For |
Radiation therapy | Uses powerful energy beams. | People whose POEMS syndrome is limited to a small area. |
Chemotherapy | Treats POEMS with strong medicines. | People whose POEMS syndrome is more advanced. |
Bone marrow transplant | Puts healthy bone marrow stem cells into the body to help bone marrow work better. | Some people with advanced POEMS syndrome. |
Physical therapy | Can help with the weakness and other symptoms of polyneuropathy. | People managing polyneuropathy symptoms. |
Preparing for Your Appointment
You might start by seeing your primary healthcare professional. You may be sent to a specialist in blood conditions, called a hematologist.
When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a certain test. Make a list of your symptoms, including any that seem unrelated to the reason for your appointment, and when they began; key personal information, including major stresses, recent life changes and family medical history; all medicines, vitamins or other supplements you take, including the dosages; and questions to ask your healthcare professional.
Take a family member or friend along, if possible, to help you remember the information you get.
For POEMS syndrome, some basic questions to ask your healthcare professional include: What's likely causing my symptoms? What tests do I need? Is my condition likely to go away or to last? What's the best course of action? I have these other health conditions — how can I best manage them together? Are there restrictions I need to follow? Are there brochures or other printed material I can have? What websites do you suggest?
Your healthcare professional is likely to ask questions, such as: Do you always have your symptoms or do they come and go? How bad are your symptoms? What, if anything, seems to ease your symptoms? What, if anything, seems to make your symptoms worse?
Conclusion
POEMS syndrome is a rare blood disorder that damages nerves and affects many parts of the body. Its name reflects its core symptoms — polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes — and every person with the condition has both polyneuropathy and monoclonal protein. There is no cure, but treatment with radiation therapy, chemotherapy, stem cell transplant, and physical therapy might improve symptoms, and the outlook has improved greatly over the past decade. Because the condition worsens quickly without treatment, early diagnosis is vital.
Next step: If you have numbness or tingling in your legs, trouble breathing, unexplained swelling, or skin changes that have developed over weeks to months — especially if you're over age 50 — make an appointment with your healthcare professional. Bring a list of all your symptoms, medicines, and family medical history, and ask about referral to a hematologist, since POEMS syndrome often requires a specialist's evaluation.
Frequently Asked Questions (FAQ)
What is POEMS syndrome?
POEMS syndrome is a rare blood disorder that damages nerves and affects other parts of the body. POEMS stands for the symptoms of the condition: polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes.
What does POEMS stand for?
P stands for polyneuropathy, O for organomegaly, E for endocrinopathy and edema, M for monoclonal protein, and S for skin changes. Everyone with POEMS syndrome has polyneuropathy and monoclonal protein.
What are the symptoms of POEMS syndrome?
Symptoms most often appear over weeks to months and may include numbness, tingling and weakness in the legs, trouble breathing, an enlarged spleen, liver or lymph nodes, atypical hormone levels causing an underactive thyroid or diabetes, swelling in arms and legs, and skin changes such as more color, red spots, thicker skin, or more hair on the face or legs.
What causes POEMS syndrome?
Experts don't know the cause. People with POEMS syndrome have a higher number of plasma cells that make too much monoclonal protein, which goes into the bloodstream and can damage other parts of the body.
Is POEMS syndrome curable?
There's no cure for POEMS syndrome, but treatment might improve symptoms. Treatments may include radiation therapy, chemotherapy, and stem cell transplant, and the outlook has improved greatly over the past decade or so.
How is POEMS syndrome diagnosed?
Diagnosis involves a medical history, physical exam, and neurological exam, plus tests such as EMG studies, nerve biopsy, CT or PET scans, blood tests including a complete blood count, and 24-hour urine collection. It can be hard to diagnose because symptoms are complex and affect many organs.
Who is at risk for POEMS syndrome?
POEMS syndrome most often happens after age 50, and people assigned male at birth are a bit more likely to get it than people assigned female at birth.
What is PEST in relation to POEMS syndrome?
PEST describes other symptoms some people with POEMS syndrome have: papilledema (swelling in the back of the eyes), extravascular volume overload (ankle swelling, fluid between the lung and ribs, or fluid in the belly), sclerotic bone lesions (bone spots on X-rays, most often not painful), and thrombocytosis and erythrocytosis (higher levels of red cells and platelets in the bloodstream).
References and Further Reading
Primary clinical sources: POEMS Syndrome — Symptoms & Causes overview; POEMS Syndrome — Diagnosis & Treatment overview.
External references (official sources):
References
Editorial note: This article is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment decisions. Content based on current clinical guidance and published medical sources; reviewed August 2026.
Health information, not medical advice. This article is for general education and is not a substitute for professional diagnosis or treatment. Always consult a qualified healthcare provider about your own health, and seek emergency care for urgent symptoms.
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