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POEMS syndrome: an unusual cause of exuberant callus formation
  1. Bhanu Malhotra1,
  2. Ashwini Sood2,
  3. Pankaj Malhotra3 and
  4. Sanjay Bhadada1
  1. 1Endocrinology, PGIMER, Chandigarh, Haryana and Punjab, India
  2. 2Nuclear medicine, PGIMER, Chandigarh, Haryana and Punjab, India
  3. 3Hematology, Internal Medicine, PGIMER, Chandigarh, Haryana and Punjab, India
  1. Correspondence to Dr Sanjay Bhadada; bhadadask{at}


Several growth factors are expressed in distinct temporal and spatial patterns during fracture repair. Together, they lead to angiogenesis–osteogenesis coupling and hence bone healing by callus formation. Of these growth factors, vascular endothelial growth factor is of particular interest because of its ability to induce neovascularisation (angiogenesis) and osteoclast invasion in soft callus. Hyperplastic callus can be seen in metabolic bone disease, endocrine disease and in patients with traumatic brain injury, but has not been described so far in polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes (POEMS) syndrome. This report is a case of POEMS syndrome with unusual presentation in the form of exuberant callus formation at fracture sites.

  • Endocrine system
  • Haematology (drugs and medicines)

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  • Contributors Study conception and design: BM and SB. Nuclear scans: AS. Haematology opinion: PM. Draft manuscript and preparation: BM and SB. All authors have reviewed and approved the final version of the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.