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Elevated levels of interleukin-1 beta (IL-1 beta) and IL-6 in serum and
increased production of IL-1 beta mRNA in lymph nodes of patients with
polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes
(POEMS) syndrome
RK Gherardi, L Belec, G Fromont, M Divine, D Malapert, P Gaulard and JD Degos
Departement de Pathologie, Hopital Henri Mondor, Creteil, France.
To evaluate a possible implication of cytokines in the pathogenesis of
polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes
(POEMS) syndrome, we studied five consecutive patients with this condition,
of which four had sclerotic bone lesions and four had multicentric
Castleman's disease. Interleukin-1 beta (IL-1 beta) and IL- 6 serum levels
were determined in these patients (13 serum samples) and in patients with
multiple myeloma (5) and Waldenstrom's macroglobulinemia (5). In situ
hybridization of the relevant mRNAs was performed on lymph node specimens
of two patients with POEMS syndrome who had Castleman's disease. Elevated
serum levels of IL-1 beta (13/13 samples), and IL-6 (7/13 samples) were
found in patients with POEMS syndrome. In the other patients, serum IL-1
beta was undetectable or slightly increased and IL-6 was elevated in a
single patient with Waldenstrom's macroglobulinemia. Abundant IL-1 beta
mRNA-producing cells were present in interfollicular spaces in the two
tested patients, while IL-6 mRNA-producing cells were rare. We conclude
that IL-1 beta and IL-6 serum levels may be chronically elevated in
patients with POEMS syndrome, and that lymph node may be one site of IL-1
beta overproduction. These results are in keeping with the hypothesis that
cytokines mediate systemic manifestations of POEMS syndrome.
Volume 83,
Issue 9,
pp. 2587-2593,
05/01/1994
Copyright © 1994 by The American Society of Hematology
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