Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of Crow-Fukase syndrome showing improvement following excision and irradiation of bone lesions

Asako Yoritaka, M.D., Miwa Sakai, M.D., Keiko Ohta, M.D. and Shuji Kishida, M.D.

Department of Neurology Tokyo Metropolitan Komagome Hospital

A 57-year-old woman suffering from pleural and pericardial effusion, pulmonary hypertention, lymphadenopathy, hepatosplenomegaly, edema, hypertrichosis, small hemangioma and polyneuropathy was diagnosed as Crow-Fukase syndrome. Osteoctomy of the left second rib and irradiation of this rib and the left iliac bone were performed. Serum vascular endothelial growth factor (VEGF) level decreased to less than one-half the level before the operation (from 5,180 to 2,150 pg/ml). Immediately after the operation, pleural and pericardial effusions due to hyperpenetration improved, and polyneuropathy and hypertrichosis due to hypervasularity also gradually improved. The resected lesion was histopathologically found to be of a plasmacytoma of the IgGλtype. Since the level of VEGF in the tissue specimen was much lower (116 pg/ml) than that in the serum, VEGF could not have been produced by the plasmacytoma.

(CLINICA NEUROL, 44: 369|371, 2004)
key words: Crow-Fukase syndrome, POEMS syndrome, VEGF, osteostomy

(Received: 27-Nov-03)