Israel Medical Association Journal

Polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma-cell disorder, and skin changes (POEMS syndrome) is a rare multisystem paraneoplastic disorder driven by a plasma-cell dyscrasia and cytokine overproduction. It is often misdiagnosed as chronic inflammatory demyelinating polyneuropathy (CIDP) due to overlapping neuropathy [1]. Although thrombocytosis is typical, immune thrombocytopenia is a rare and underrecognized presentation. We describe a patient with longstanding immune thrombocytopenic purpura (ITP) that evolved to POEMS, developed sinusoidal obstruction syndrome (SOS) after an autologous stem-cell transplantation (ASCT), and remained cytopenic due to hypersplenism, highlighting diagnostic and therapeutic challenges.

There is a high prevalence of olfaction changes, especially in the early presentation, in COVID-19 patients. The mechanisms through which the virus leads to anosmia/hyposmia is still not fully understood. However, olfaction changes could be used as an indication for testing or quarantine. Screening for infections and other diseases by recognizing volatile organic compounds (VOCs) has been previously conducted. Hence, if the coronavirus infection also results in VOCs excretion, physicians could “smell” the virus by using electronic noses. We conducted a literature review on olfaction changes and the COVID-19. Our results suggest that these changes could be used an indication for early testing, even as an isolated symptom. We propose that the electronic nose be used as a future screening tool, especially in agglomeration spaces such as airports, for screening for the COVID-19 infection