Zhaojie Qin

Polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS) syndrome is frequently mistaken for chronic inflammatory demyelinating polyneuropathy, as its clinical profile is highly variable and neurological symptoms often dominate the initial course. In the present case, the disorder initially presented as cardiovascular dysfunction, which delayed decision-making related to the original diagnosis. As the condition advanced, the patient developed progressive limb weakness, splenomegaly, and abnormalities in lipid metabolism. Whole-body bone scintigraphy revealed osteolytic lesions in association with a plasmacytoma, whereas the serum vascular endothelial growth factor levels were markedly elevated. Based on the cumulative findings, POEMS syndrome was diagnosed. Treatment with interventional chemotherapy combined with adjunctive symptomatic care resulted in a marked reduction in symptoms and promoted functional recovery. This case provides detailed clinical evidence highlighting the critical importance of early recognition and accurate diagnostic evaluation in POEMS syndrome. By aligning our observations with the existing literature, we emphasize strategies that promote timely diagnosis, minimize diagnostic error, and improve therapeutic outcomes.

Osteoporosis affects more than 200 million women worldwide, with postmenopausal women being particularly susceptible to this condition and its severe sequelae disproportionately, such as osteoporotic fractures. To date, the current focus has been more on symptomatic treatment, rather than preventive measures. To address this, we performed a meta-analysis aiming to identify potential predictors of osteoporotic fractures in postmenopausal women, with the ultimate goal of identifying high-risk patients and exploring potential therapeutic approaches. We searched Embase, MEDLINE and Cochrane with search terms (postmenopausal AND fracture) AND (“risk factor” OR “predictive factor”) in May 2022 for cohort and case–control studies on the predictors of osteoporotic fracture in postmenopausal women. Ten studies with 1,287,021 postmenopausal women were found eligible for analyses, in which the sample size ranged from 311 to 1,272,115. The surveyed date spanned from 1993 to 2021. Our results suggested that age, BMI, senior high school and above, parity ≥ 3, history of hypertension, history of diabetes mellitus, history of alcohol intake, age at menarche ≥ 15, age at menopause < 40, age at menopause > 50, estrogen use and vitamin D supplements were significantly associated with osteoporotic fracture in postmenopausal women. Our findings facilitate the early prediction of osteoporotic fracture in postmenopausal women and may contribute to potential therapeutic approaches. By focusing on preventive strategies and identifying high-risk individuals, we can work toward reducing the burden of osteoporosis-related fractures in this vulnerable population.