POEMS syndrome is a paraneoplastic syndrome due to an underlying plasma cell neoplasm. The major criteria for the syndrome are polyradiculoneuropathy, clonal plasma cell disorder (PCD), sclerotic bone lesions, elevated vascular endothelial growth factor, and the presence of Castleman disease. Minor features include organomegaly, endocrinopathy, characteristic skin changes, papilledema, extravascular volume overload, and thrombocytosis. it was reactive. Due to high ESR and globulin levels, we

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... e analyzed immunoglobulin levels. The results were as follows ; IgA: 524 mg/dl (45-380 mg/dl), IgM : 156 mg/dl (40-230 mg/dl), IgG: 1390 mg/dl (650 -1600 mg/dl) Free light chain kappa(κ): 9.12 mg/dl( 0.67 -2.24 mg/dl ), Free light chain lambda(λ): 27.6 mg/dl( 0.83-2.7 mg/dl), Free light chain κ/λ ratio: 0.33(0.31-1.56). Beta-2 microglobulin: 10271 ng/mL (651-2295 ng/mL), immunfixatiton electrophoresis and protein electrophoresis revealed that there was IgA lambda monoclonal gammopathy and beta gamma monoclonal band respectively ( Figure 2) . Unfortunately, in this case, the serum level of the vascular endothelial growth factor (VEGF) was not assessed. Bone marrow aspiration and biopsy were performed Figure 1: Bilateral pleural effusion.