VEGFA and Ascites: VEGF is a cytokine that has been proposed recently as a marker of severe depression, raising the possibility of a link between immunological changes and development of affective symptoms in the context of POEMS syndrome.27 Multivariate logistic regression identified only upper limb ONLS scores (P = 0.02) and the presence of ascites (P = 0.04) as independent predictors of clinical depression.