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POEMS syndrome with atypical presentation: A rare case
S Singhal1, M M Bharath1, R Verma2
1Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Abstract:
POEMS is an uncommon paraneoplastic plasma cell disorder known with the expansion of polyneuropathy, organomegaly, endocrine abnormalities, M-band, and skin changes. We report a patient presenting with monoarthritis and weight loss for 5 months, who was treated empirically for tuberculous arthritis and later developed debilitating axonal polyneuropathy due to delayed diagnosis. POEMS/Plasma cell dyscrasias rarely involve joints, and this case highlights this unique presentation of POEMS syndrome. Bone biopsy from the affected joint revealed the diagnosis. Chronic large-joint monoarthritis with systemic symptoms, mimicking tuberculous arthritis, and polyneuropathy is a unique combination-so clinicians should consider an underlying plasma cell dyscrasia/POEMS to avoid delayed diagnosis.
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