Introduction: POEMS syndrome consisting of polyneuropathy (P), organomegaly (O), endocrinopathy (E), monoclonal gammopathy (M) and skin changes (S), is a rare paraneoplastic syndrome resulting from an underlying plasma cell disorder. The multi-organ involvement associated with this syndrome extends beyond those listed in the acronym, such as extravascular volume overload (pleural effusion, ascites, oedema), sclerotic bone lesions, papilledema and thrombocytosis, and not all of the features listed in the acronym are required for diagnosis. Observation: we report a rare case of POEMS syndrome in an 83-year-old man with bilateral pleural effusions, initially attributed to pleural tuberculosis given the endemic context. Conclusion: the pleural involvement in patients with POEMS in our endemic tuberculosis context makes diagnosis difficult, delaying treatment. However, a good history and physical examination followed by appropriate investigations can differentiate this syndrome from other diseases.
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