The patient is a 40-year-old female who presented with breathlessness, fatigue, arthralgia, weight loss, and swelling in the legs. Investigations revealed hypothyroidism, pulmonary hypertension, anemia, and signs of autoimmune disease. Over time she developed additional symptoms affecting multiple organs. Based on her symptoms and test results, she was diagnosed with POEMS syndrome, a rare paraneoplastic condition characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma proliferation, and skin changes. She was treated with steroids, thyroid medication, diuretics, and pain medications.

1. PROF.DR.NOORUL AMEEN PANDICHELVAN M6

26. ASCITIC FLUID ANALYSIS Protein-4.4 Sugar-92 Aalbumin-1.2 SAAG -2.66 Cell count - 96%lymphocytes;4%mesothelial cells= Cytology- clusters of reactive mesothelial cells and few lymphocytes in a eosinophilic background-reactive effusion Mantouex test : Negative