These additional features include papilledema, extravascular fluid overload, sclerotic bone lesions, thrombocytosis/erythrocytosis, elevated vascular endothelial growth factor (VEGF), and abnormal pulmonary function tests.2 The incidence of POEMS syndrome is unknown in the United States, but in Japan it is estimated to be around 0.3 per 100 000 habitants.3 This evidence concerns the gene VEGFA and POEMS syndrome.