Objective  To analyze clinical visit patterns and the reasons pertaining to misdiagnosis and missed diagnosis of POEMS syndrome.

  Methods  The clinical data, including age, sex, symptoms, and process of arriving at the initial diagnosis, of 30 patients with POEMS syndrome in our hospital were analyzed retrospectively.

  Results  The median patient age was 51 (26−67) years, and the ratio of males to females was 1.1:1. The median number of visits and median time from onset to definite diagnosis were 3 (1−6) times and 13 (1.5−13.2) months, respectively. Though the departments of neurology, nephrology, endocrinology, and digestion were initially visited by the patients, the department with the most diagnoses was hematology. Twenty-six (87%) patients experienced misdiagnosis or missed diagnosis. The common initial diagnoses included Guillain-Barré syndrome, peripheral neuropathy, and unknown diagnosis. Additionally, nearly half of the original diagnoses were changed during the patients’ visiting process since then, wherein only some patients were suggested of having POEMS syndrome, but none of them were further examined. The treatment regimen administered before a confirmed diagnosis included supportive therapy, intravenous immunoglobulin combined with glucocorticoid implosive therapy, glucocorticoid therapy, and observation; 73% (19/26) of patients experienced exacerbation of their condition during treatment. Furthermore, the clinical manifestations of POEMS syndrome were highly heterogeneous and not easily recognized by the consulting physicians. Clinicians tend to focus on symptoms and signs related to their specialty, ignoring clinical manifestations beyond the scope of their specialty—this is the main reason for misdiagnosis and missed diagnosis.

  Conclusions  Misdiagnosis and missed diagnosis are common in POEMS syndrome owing to its rarity and clinical heterogeneity. These lapses can be effectively reduced if clinicians associate clinical manifestations both with their respective field and other fields, thereby strengthening multidisciplinary cooperation.