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We studied tumor necrosis factor-x(TNF-x)levels in serial serum samples from 3 consecutive patients who had a complete form of POEMS (polyneuropathy,organomegaly,endocrinopathy,M protein,skin changes) syndrome and early weight loss.Serum TNF-x levels were compared with those of 10 patients with multiple myeloma(5)or Waldenstrom's macroglobulinemia (5).Elevated serum levels of TNF-x were found in the patients with POEMS syndrome(two-to eightfold increase in 10 of 11 samples)and not in those with other malignant plasma cell dyscrasias.These results are in keeping with the hypothesis of a role for nonimmunoglobulinic mediators in the pathogenesis of the POEMS syndrome,and are consistent with previous reports of TNF-x overproduction in inflammatory demyelinating neuropathies and cachectic states. |
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