VEGFA and POEMS syndrome: Thus, we propose that the mechanism underlying the peripheral neuropathy in POEMS syndrome is due to endothelial injury, indirectly or directly caused by an abnormal activation of endothelial cells by VEGF, which is overexpressed in the nerves of patients with POEMS syndrome, thereby inducing microvascular changes and impaired vascular permeability [7, 17, 20, 89].