Open AccessTuberculous rheumatism “Poncet's disease”. Case report
Author(s) -
Gustavo Esteban Lugo-Zamudio,
Rosa Elda Barbosa-Cobos,
Laura Virginia González-Ramírez,
Dolores Delgado-Ochoa
Publication year - 2016
Publication title -
cirugía y cirujanos
Language(s) - English
Resource type - Journals
ISSN - 2444-0507
DOI - 10.1016/j.circen.2016.02.009
Subject(s) - medicine , tuberculosis , polyarthritis , rheumatoid factor , dermatology , rheumatoid arthritis , arthritis , pathology , immunology
BackgroundDeaths due to tuberculosis have reached 2.5 million cases per year worldwide. Poncet's disease is an infrequent form of tuberculosis characterised by a clinical picture of polyarthritis.Clinical caseA 24-year-old male presented with morning stiffness, arthralgias, bilateral symmetric arthritis of the proximal interphalangeal joints, wrists, knees, ankles, and shoulders, and adenomegalies at the cervical, submandibular, left supraclavicular, axillary and inguinal levels, without fever. Laboratory results were as follows: ESR 44mm/h, C-reactive protein 4.35, normal levels of complement C3 and C4, negative rheumatoid factor and anticyclic citrullinated peptide antibodies, positive antinuclear antibodies with fine speckled pattern (1:320) and cytoplasm (1:160) pattern and negative anti-Smith, -double-stranded DNA, Sjogren's syndrome-antigen A and Sjogren's syndrome-antigen B. Histological report of cervical node tissue revealed granulomatous lesions compatible with tuberculosis. Rheumatoid arthritis and systemic lupus erythematosus were ruled out. Anti-tuberculosis agents were initiated that resolved the clinical picture. Diagnosis of Poncet's disease was confirmed.ConclusionThe differential diagnosis between tuberculosis and autoimmune inflammatory joint diseases is a clinical challenge