POEMS syndrome is a rare paraneoplastic syndrome secondary to a plasma cell 
dyscrasia. Recognition of a combination of peripheral neuropathy, organomegaly, 
endocrinopathy, monoclonal plasmaproliferative disorder, skin changes, 
papilledema, extravascular volume overload, sclerotic bone lesions, 
thrombocytosis, and Castleman disease is the first step in managing the disease. 
Increased blood levels of vascular endothelial growth factor are usually 
confirmatory. This rare disorder should not be missed, especially if the patient 
has a putative diagnosis of chronic inflammatory polyradiculoneuropathy, a 
lambda restricted monoclonal gammopathy, and thrombocytosis, and is not 
responding as expected to immunomodulatory therapy commonly used for chronic 
inflammatory polyradiculoneuropathy.