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Association of osteonecrosis of the jaws and POEMS syndrome in a patient assuming rituximab.
[waldenström macroglobulinemia]
POEMS
syndrome
,
is
a
rare
condition
characterized
by
polyneuropathy
,
organomegaly
,
endocrinopathy
,
monoclonal
proteinaemia
,
and
skin
lesions
.
We
report
a
rare
case
of
a
patient
affected
by
Waldenström
macroglobulinemia
,
who
developed
POEMS
syndrome
and
who
presented
at
the
time
of
diagnosis
with
oral
manifestations
of
the
lymphoma
and
an
osteonecrosis
of
the
jaw
(
ONJ
)
after
rituximab
treatment
.
Although
the
etiology
of
ONJ
is
not
known
,
it
is
likely
that
several
factors
are
at
play
,
including
endothelial
cell
damage
,
decreased
angiogenesis
,
and
microvascular
compromise
.
Our
patient
was
treated
with
rituximab
for
a
long
period
,
and
recent
studies
have
demonstrated
the
possibility
that
rituximab
,
a
monoclonal
antibody
directed
against
the
CD
2
0
can
exert
part
of
its
anti-
tumor
action
,
through
its
action
on
angiogenesis
.
Although
our
report
does
not
allow
identification
of
rituximab
as
a
new
risk
factor
for
the
onset
of
the
ONJ
,
further
studies
seem
necessary
to
exclude
a
role
of
the
antibody
in
the
alterations
of
angiogenesis
that
could
lead
to
the
development
of
the
syndrome
after
rituximab
treatment
.
Diseases
Validation
Diseases presenting
"through its action on angiogenesis"
symptom
waldenström macroglobulinemia
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