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POEMS syndrome is a rare paraneoplastic condition related to an abnormal proliferation of plasma cells. Allergic-type reactions to gadolinium-based MR contrast media are likewise uncommon adverse events. In this report, we present a highly unusual case involving the collision of these 2 entities. Because the reaction developed unrecognized during the course of the MR examination, the case provides not only a review of the major radiological manifestations of POEMS syndrome, but also a unique insight into the imaging features of an acute contrast reaction. We briefly discuss the incidence and classification of allergic-type contrast reactions and explore possible associations with hematologic dyscrasias.