POEMS syndrome (Crow-Fukase syndrome) is a multisystem disorder characterised by polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes. Vascular endothelial growth factor (VEGF) is significantly elevated in serum and used as a good biomarker for diagnosis and disease activity.1 VEGF is a potent, multifunctional cytokine that induces angiogenesis and microvascular hyperpermeability. In POEMS syndrome, VEGF is mainly produced by plasma cells in bone lesions and lymph nodes. In the circulation, excess VEGF is mainly stored in platelets and released during platelet aggregation leading to markedly increased local VEGF concentration. …