VEGFA and Adrenal insufficiency: Patient 4 had peripheral neuropathy, blood electrophoresis results showed elevated λ light chain protein and VEGF levels, organ enlargement, multiple serous cavity effusion, and multiple biochemical tests assisting in the diagnosis of hypothyroidism, adrenal insufficiency, and other endocrine disorders, leading to a diagnosis of variant-type POEMS syndrome associated with Castleman's disease.