POEMS-associated MCD requires both major criteria (polyneuropathy and monoclonal proliferation of plasma cells), at least one of the other major criteria (CD, sclerotic bone lesions, and elevated VEGF), and one minor criterion (organomegaly such as hepatosplenomegaly, volume overload, endocrinopathies, and skin changes) [10]. The gene discussed is VEGFA; the disease is Cowden disease.