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Given the presence of both mandatory major criteria (polyneuropathy and monoclonal plasma cell proliferative disorder), at least one other major criteria (sclerotic bone lesions), and at least one minor criteria (skin changes, extravascular volume overload, endocrinopathy), as well as other associations (vitamin B12 deficiency), the patient was diagnosed with POEMS syndrome

Nevertheless, it is important to understand that not all makeup water and cooling tower blowdown sources are as simple as those depicted in Figure 1

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Weber said his patients have relayed positive anecdotes regarding peptide use -- but cautioned such anecdotes are not enough to guide use more broadly, without deeper research