Reactive arthritis in tuberculosis: A case of Poncet’s disease

  • Irmi ZI
  • Zaiton A
  • Faezah H
Keywords: Reactive arthritis, tuberculosis, Poncet’s disease, rheumatologic disease

Abstract

Reactive arthritis and erythema are uncommon presentations of tuberculosis (TB). Reactive arthritis in tuberculosis (TB) is known as Poncet’s disease, a rare aseptic form of arthritis observed in patients with active TB. We report a case of Poncet’s disease in a 20-year old man whose reactive arthritis overshadowed other clinical symptoms of TB resulting in delayed diagnosis and treatment. Although a conclusive diagnosis of Poncet’s disease is not possible, reactive immunologic reactions such as reactive arthritis and erythema nodosum even without respiratory symptoms should raise suspicion on possible TB. Thus, taking a thorough medical history as well as performing relevant examinations and investigations for possible TB will help expedite the diagnostic process.

References

World Health Organisation. Global Tuberculosis Control: WHO Report 2011. Geneva: WHO Press. 2011

World Health Organisation. Tuberculosis Control in the Western Pacific Region: 2010 Report. Geneva: WHO Press; 2010.

Aziah AM. Tuberculosis in Malaysia: combating the old nemesis. Med J Malaysia. 2004; 59(1): 1-4

Chang CT, Esterman A. Diagnostic delay among pulmonary tuberculosis patients in Sarawak: a cross-sectional study. Rural and Remote Health. 2007;7:1-8.

Kroot EJA, Hazes JMW, Colin EM, Dolhain RJEM. Poncet’s disease: reactive arthritis accompanying tuberculosis. Two case reports and a review of the literature. Rheumatology. 2007;46: 484–9.

Ideguchi H, Ohno S, Takase K and et al. A case of Poncet’s disease (tuberculous rheumatism). Rheumatol Int. 2009; 29:1097–9. doi 10.1007/s00296-008-0795-1.

Chopra A, Joshi VL, Joshi V, Rane R, Anuradha V. Old enemy on a difficult terrain: tuberculosis in rheumatology practice with focus on uncommon extrapulmonary affection. Indian Journal of Rheumatology. 2011; 6(1): pp. 44–54.

Rihl M, Klos A. Reactive arthritis. Best Practice & Research Clinical Rheumatology. 2006;20(6):1119-37.

Hannu T. Reactive arthritis or post infectious arthritis? Best Practice & Clinical Rheumatology. 2006;20(3):419-33.

Hannu T, Mattila L and et al. Compylobacter-triggered reactive arthritis: a population based study. Rheumatology. 2002;41:312-8.

Toivanen A, Toivanen R. Reactive arthritis. Best Practice & Research Clinical Rheumatology. 2004; Vol. 18(5), pp. 689–703.

Storla DG, Yimer S, Bjune GA. A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health. 2008; 8: 15. doi 10.1186/1471-2458-8-15.

Haldar S, Ghosh P, Ghosh A. Tuberculous arthritis-the challenges and opportunities: observations from a tertiary center. Indian Journal of Rheumatology. 2011; 6(1):62-8.

Oguntono AR, Adelowo OA, Oghenetega O. Poncet’s disease (tuberculous rheumatism) in Nigeria: A case report. Nigerian Medical Practitioner. 2008;53(3):26-7.

Whig J, Mahajan V, Kasyap A, Gupta S. Erythema Nodosum: Atypical presentation of common disease. Lung India. 2010; 27:181-2.

Heinemann C, Kaatz M, Elsner M. Erythema induratum of Bazin and Poncet’s disease – successful treatment with antitubercular drugs. Journal of the European Academy of Dermatology and Venereology. 2003; 17(3):334–6.

Amstrong C. AHA Guidelines on Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal Pharyngitis. Am Fam Physician. 2010;81(3):346-59

Smith I. Mycobacterium tuberculosis Pathogenesis and Molecular Determinants and Virulence. Clin. Microbiol. Rev. 2003;16(3):463-96.

Abdulaziz S, Almoallim H, Ibrahim A, Samannodi M, Shabrawishi M, Meeralam Y, Abdulmajeed G, Banjar G, Qutub W, Dowaikh H. Poncet’s disease (reactive arthritis associated with tuberculosis): retrospective case series and review of literature. Clin Rheumatol. 2012; 31:1521– 8.

Heidari B, Buani K. Poncet’s disease: A report of four cases and review of the literature. Medical Journal of the Islamic Republic of Iran. 2003; 17(1): 81-3.

Psychos DN, Voulgari PV, Skopouli FN, et al. Erythema Nodosum: the Underlying Conditions. Clin Rheumatol. 2000 19:212–6.

Anantham D, Ong SJ, Chua KL, Fook-Chong S, Hsu A, Eng P. Sarcoidosis in Singapore: Epidemiology, clinical presentation and ethnic differences. Respirology. 2007; 12, 355–60.

Published
2012-03-31
How to Cite
ZI, I., A, Z., & H, F. (2012). Reactive arthritis in tuberculosis: A case of Poncet’s disease. Malaysian Family Physician, 8(1), 4. Retrieved from https://www.e-mfp.org/ojs3/index.php/MFP/article/view/110
Section
Original Articles