VEGFA and POEMS syndrome: Therefore, the clinical misdiagnosis and delayed diagnosis rates of POEMS syndrome are high, and the delayed diagnosis time can be up to 2 years.[3] The pathogenesis of POEMS syndrome is not completely clear, but it has been hypothesized that abnormally high serum concentrations of VEGF trigger a variety of symptoms.[4] Some studies have confirmed that platelets[5] or plasma cells[6,7] are the main source of VEGF; therefore, the authors believe that clonal plasma cells drive the development of the whole disease.