• Hai-Ping Huang, Hong-Mei Ran, Zheng-Sheng Li, and Juan Xie.
• Department of Nephrology, The Second Affiliated Hospital of Guizhou University of TCM, Guiyang, China.
• Medicine (Baltimore). 2024 Mar 1; 103 (9): e37200e37200.

RationaleThis article presents the case of a patient with recurrent chronic diarrhea and cachexia who was misdiagnosed, followed by a literature review to summarize the reasons for misdiagnosis of POEMS syndrome and the treatment strategies.Patient ConcernsThe diagnosis and treatment of this patient suggest that with the improvement of M-protein detection levels, the diagnosis of patients with low M-protein levels, such as those with POEMS syndrome, has been greatly aided.DiagnosesPOEMS syndrome requires polyneuropathy and monoclonal plasma cell proliferation as mandatory diagnostic criteria. Therefore, patients presenting with polyneuropathy should routinely undergo M-protein testing and consider the possibility of POEMS syndrome.InterventionsThe patient, in this case, was treated primarily with relatively conservative immunomodulatory agents.OutcomesDuring follow-up after treatment, the patient's diarrhea and malnutrition showed significant improvement.Lessons SubsectionsPOEMS syndrome has low clinical specificity and a high rate of misdiagnosis. However, once a definitive diagnosis is made, the treatment outcome is favorable.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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