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Background: POEMS syndrome is a debilitating paraneoplastic disorder associated with plasma cell neoplasia. Clinically, it is characterized by predominantly demyelinating peripheral neuropathy that often starts in the pelvic limbs, organomegaly, endocrinopathy, skin changes, and elevated serum M protein. Diagnosis requires meeting a set of clinical criteria in which polyradiculoneuropathy and plasma cell disorder are the two mandatory criteria. The aim of this article is to describe 3 clinical cases, their diagnostic approach, and therapeutic management. Clinical cases: In this study, three clinical cases with features compatible with POEMS syndrome are presented. Nerve conduction studies revealed demyelinating involvement with sensory-motor impairment, and evidence of a monoclonal spike was found. Treatment was successful in two cases and partially effective in one, although the latter was associated with delayed diagnosis. Conclusion: Despite significant advancements in understanding the pathophysiology and treatment of this disease, diagnosis remains challenging, especially in locations lacking the necessary resources for accurate diagnosis. It is essential to emphasize that it requires a multidisciplinary approach. The prognosis of this disease is closely linked to early diagnosis. Here, we describe three cases from a reference center in Mexico to increase awareness of the disease›s diagnosis. [ABSTRACT FROM AUTHOR]

Background: Acute intermittent porphyria (AIP) is an uncommon metabolic disease, being the most common of the acute porphyrias. The most frequent symptom is acute abdominal pain, although can be accompanied by seizures, neuro-psychiatric alterations or symmetrical motor neuropathies, which in some patients can progress to respiratory musculature paralysis. Objective: Describe an atypical presentation of acute porphyria to be considered as differential diagnoses in abdominal pain. Clinical case: We present a case of a patient with AIP, presenting acute abdomen, seizures, later developed neuropsychiatric compromise and symmetrical motor neuropathy, and was admitted to mechanical ventilation. Due to the severity of the neurological involvement, he received hemin arginate, presenting with transient hypertransaminemia, an adverse event not previously reported. The evolution was favorable, with mechanical ventilation and hospital discharge withdrawn. Conclusions: The diagnosis of AIP should be considered in cases of acute abdominal pain associated with neurological and/or psychiatric symptoms, particularly young women. The administration of hemin is considered the standard of treatment, and even late could have beneficial effects. [ABSTRACT FROM AUTHOR]

Background: Diabetic neuropathy represents a polyneuropathy with electrophiosiological alterations. Electroneuromyography (NMD) plays an important role in the evaluation of patient with diabetes mellitus type 2 (DM2) and doubtful neuropathy. Objective: To determine clinical manifestations in patients with distal symmetrical sensory polyneuropathy (DSSP) and to correlate them with electromyographic alterations. Material and methods: Transversal, analytical study. 138 patients over 18 years old, with DM2 and PSSD were selected. They underwent physical examination, laboratory studies and electromyography (EM) with 4-channel Nicolet electromyograph. Measures of central tendency and their dispersion were analyzed; data normality with Kolmogorov-Smirnov; Student's t test and Spearman's correlation. Results: Thalar hyperkeratosis was the most frequent clinical finding in 103 (74%) patients. The most frequent symptoms were paresthesia in 132 (95.7%) patients and tingling in 93 (67.4%) patients. Exploration of superficial sensitivity determined neuropathy in 42 (30.4%) patients finding greater insensitivity in the medial plantar nerve territory. In the EM, the nerve with the greatest absent response was the left lateral plantar nerve in 51 (59%) patients. A significant correlation (p < 0.05) was found between the variables of EM with age, years of evolution and levels of glycated hemoglobin A1c. Conclusions: The higher the lack of glycemic control, the chronobiology of the patient and the time of illness, the greater the electromyographic affection. [ABSTRACT FROM AUTHOR]

Background: Guillain-Barré syndrome (GBS) has a cosmopolitan distribution. Its course is usually mild and tends to limit itself, but in severe cases it can cause death. The aim of this article is to describe the characteristics of a group of adults with GBS diagnosed and treated at a university hospital. Methods: All cases of GBS that occurred between January 1, 2005 to December 31, 2009 were analyzed. The clinical records were reviewed through the implementation of a structured survey that included the following sections: patient identification, clinical data, history of infection, season of occurrence, rates of electrophysiological variants, and lethality. Results: A total of 45 patients were included; the male to female ratio was 1.4: 1 and the mean age was 48.2 ± 16.0 years. The season with the highest number of cases was the summer. History of intestinal infection was present in 40% of patients, and respiratory infection in 24.4%. The lethality associated with GBS was 11.1% (95% CI, 4.4-23.9), fatal cases occurred in patients older than the survivors (65.2 ± 15.0 versus 46.0 ± 14.9, p = 0.01). The most common variant was acute motor axonal neuropathy (64.4%); there were four cases of Miller Fisher syndrome. Conclusions: The most common electromyographic variant of GBS was acute motor axonal neuropathy. The highest number of cases was observed during the summer season. [ABSTRACT FROM AUTHOR]