TNF and POEMS syndrome: Bone lesions is related to the activity of interleukin-1, prostaglandin, tumor necrosis factor, and other cytokines, as well as osteoclasts.[8] In this case, we considered the differential diagnoses of MM and bone tuberculosis based on the observed bone lesions.[9] Most patients with MM present with the initial symptom of bone pain, unlike the typical presentation of POEMS syndrome.