In conclusion, we report a case of POEMS syndrome without M protein expression, in which the patient presented with polyneuropathy, multiple plasmacytoid effusions, skin pigmentation, white nails, CD, an elevated blood VEGF, sclerosing bone disease, elevated prolactin, hypothyroidism, optic papillae edema, and pulmonary hypertension. This evidence concerns the gene PRL and pulmonary arterial hypertension.