VEGFA and Pleural effusion: The patient was diagnosed with POEMS syndrome, fulfilling of the mandatory criteria of peripheral polyneuropathy and monoclonal plasma cell proliferation producing λ‐type light chain, with major criteria of Castleman disease and VEGF elevation and minor criteria of extravascular volume overload (peripheral edema, pleural effusion, and ascites), endocrinopathy (hypothyroidism), and skin change (scleroderma).