VEGFA and Pleural effusion: (V) Hematology (Suspicion Raised): Based on the combination of limb numbness and weakness, abnormal nerve conduction, unexplained cirrhosis/splenomegaly, ascites and pleural effusion, menstrual irregularity, and elevated IgA levels, POEMS syndrome was suspected., A VEGF assay, sex hormones, serum immunofixation electrophoresis, superficial lymph node ultrasound, and bone marrow examination (aspiration/biopsy/flow cytometry for clonal plasma cells) were recommended.