Poncet's Disease Research Articles

Reactive arthritis (Poncet's Disease) as initial presentation of tuberculous peritonitis

Tuberculous peritonitis is a rare condition in children that requires a high degree of clinical suspicion for detection. We report on a child who presented only with joint pain and was subsequently found to have peritoneal tuberculosis.

Poncet's disease: retrospective case series from a high endemic country with a proposal of new diagnostic criteria

Poncet's disease: retrospective case series from a high endemic country with a proposal of new diagnostic criteria

Diagnosis of acute sarcoid arthritis (Löfgren's syndrome) in India, a country with high burden of tuberculosis

ObjectiveThe present study was carried out to test if Visser et al's 2002 diagnostic criteria for acute sarcoid arthritis (Löfgren syndrome) are applicable in India, a country with high burden of tuberculosis. Methods30 consecutive patients classified as acute sarcoid arthritis according to Visser et al's criteria were included. They were screened for TB with standard Mantoux test, radiograph of chest and if found normal, contrast enhanced computerized tomography (CE-CT) of thorax. Results24 of 30 patients showed a negative Mantoux test as well as normal chest radiograph and CE-CT. These patients were labeled as acute sarcoid arthritis. There were, 6 (20%) patients who had one or more features of TB by way of a positive Mantoux test and/or mediastinal lymphadenopathy with central necrosis, or asymmetrical hilar lymphadenopathy. The latter patients were diagnosed as having Poncet's disease, a parainfectious arthritis associated with the presence of tuberculosis at a distant site way from musculoskeletal system. Therapeutic response to low-dose glucocorticoid, hydroxychloroquine and low-dose methotrexate produced dramatic results among those diagnosed with acute sarcoid arthritis. On the other hand, those diagnosed as having Poncet's disease were given standard anti-TB drugs with excellent response. ConclusionIn a country with high burden of TB like India Visser et al's clinical criteria for the diagnosis of acute sarcoid arthritis (Löfgren syndrome) may not be very specific; TB must be ruled out before diagnosing acute sarcoid arthritis (Löfgren syndrome).

THU0284 Poncet's Disease in Tuberculous Mastitis, A CASE Report

BackgroundPoncet's disease, named after a French surgeon, Antonin Poncet, is a rare form of polyarthritis occurring in patients with tuberculous infection. It is an immunological reaction to tuberculoprotein wherein CD4+...

Poncet's disease presenting as Pseudo-Behçet's disease

Poncet's disease presenting as Pseudo-Behçet's disease

Clinical features of Poncet’s disease. From the description of 198 cases found in the literature

Poncet's disease (PD) is an entity described as a reactive arthritis due to tuberculous infection elsewhere from the joints. PD existence has been questioned; however, more cases have been reported over the years. Due to its rare nature, little is known about the clinical picture of this disease and no prospective studies had been made to address this issue. We performed a systematic review of the written literature on PD in different databases using the key words "Poncet's disease," "tuberculous rheumatism," and "tuberculous reactive arthritis." Out of 78 articles, 198 patients were included in the analysis, plus our patient. Several characteristic patterns were found. Also, a review of the pathogenesis and some hypotheses are made. PD is a well-defined entity, which should be taken as a reactive arthritis for future studies given the increase in TB incidence and prevalence around the world, especially in high-burden countries.

Poncet’s disease (reactive arthritis associated with tuberculosis): retrospective case series and review of literature

The primary objective of this study is to describe the demographics and clinical characteristics of patients with Poncet's disease (PD) in the Makkah region in Saudi Arabia, where tuberculosis is on the rise. The secondary objective is conducting a PD systematic literature review to compare our findings. We studied seven patients who presented with arthritis within the first 3 years from diagnosis of active tuberculosis in two centers in the Makkah region: King Faisal Specialist Hospital and King Fahad Hospital in Jeddah from January 2005 to December 2011. We conducted a literature review on PD in multiple biomedical/pharmaceutical databases up to December 2011. We detected a new pattern of reactive arthritis associated with tuberculosis (TB). We identified this as PD or tuberculous rheumatism, which is a sterile reactive arthritis that can emerge during any stage of acute TB infection. Seven cases of Poncet's disease were identified in our study. The most common presentation was extrapulmonary with involvement of multiple sites. Six out of seven patients developed arthritis after initiation of anti-TB drugs; one patient developed polyarthritis after completion of anti-TB medication. Asymmetrical polyarthritis was the most common presentation and the resolution of the arthritis was with symptomatic treatment and continuation of anti-TB drugs except in one case. PD may manifest in a variable pattern during the course of active tuberculous infection. Physicians should be aware of this rare complication associated with a common disease to prevent delay in diagnosis and initiation of appropriate treatment.

A presentation of Poncet's disease identified following immunosuppressive steroid therapy [Correspondence

A presentation of Poncet's disease identified following immunosuppressive steroid therapy [Correspondence

Artrite de Poncet: relato de caso

Poncet's disease is a rare clinical condition, characterized by polyarticular impairment in a patient diagnosed with tuberculosis, with no evidence of direct bacillary invasion of the joints, constituting reactive arthritis. We report a case of a 56-year old, white male from the city of Porto Alegre, with evidence of additive polyarthritis of the large joints, investigated for five years, and with no defined diagnosis. The patient had undergone unilateral nephrectomy five years before, and the anatomicopathological exam of the specimen revealed renal tuberculosis. The current tuberculin test was strongly reactive (PPD = 20 mm). Analysis of the synovial fluid showed no direct bacillary invasion. Tuberculostatic treatment was initiated and clinical remission occurred after two months. The diagnosis of Poncet's arthritis was established.

Poncet's disease or tuberculous rheumatism

Poncet's disease or tuberculous rheumatism

Old enemy on a difficult terrain: tuberculosis in rheumatology practice with focus on uncommon extrapulmonary affection

One third of all cases of tuberculosis (TB) are extrapulmonary (EP) and less than 5% of these are associated with musculoskeletal (MSK) system. TB can infect MSK at several sites (spinal/axial and extra-axial/peripheral) and present with multifocal damage. Inflammatory rheumatologic disorders and immunosuppressive therapy may further compound the problem. A high index of suspicion is required. Modern imaging and microbiology-serology techniques provide early diagnosis with improved prognosis. All this was demonstrated by a retrospective analysis of case records of 23,651 patients examined in a single rheumatology center in Pune during the period 2005–2009. The study used the patient referral database to retrieve data and perform analysis. Thirty-five percent of the total cases were classified as rheumatoid arthritis (RA). Ninety-eight cases recorded TB in the case record either as a past illness or primary illness, or concurrent complication. 0.4 percent cases of RA developed TB which was predominantly pulmonary. TB affected MSK in 16 cases (0.07%) with 12 cases suspected of Poncet's disease. Two cases (1 with RA) were diagnosed as multifocal (with non-contiguous spinal disease, psoas abscess). One case each of tubercular infection of the breast and wrist (both rare forms) was associated with inflammatory arthritis. One case each of primary MSK tubercular infection of wrist extensor tenosynovitis and monoarticular knee synovitis was also recorded. TB lymphadenopathy was the commonest manifestation of extrapulmonary tuberculosis (EPTB). Though infrequent, TB remains an important differential diagnosis in rheumatology setting.

A Case of Poncet's Disease in a Patient with Pulmonary Tuberculosis Accompanying Erythema Nodosum

Poncet's disease is an aseptic polyarthritis developing in the presence of active Tuberculosis occurring elsewhere, and is not due to direct involvement of joints but to an immunological reaction to tuberculoprotein. We experienced a case of Poncet's disease accompanying erythema nodosum in a 55-year-old female patient with pulmonary tuberculosis. She had multiple tender erythematous nodules on both lower limbs for 3 months and a cough and sputum from one month ago. She felt severe pain in both knees and ankles with swelling one week before admission. Her chest X-ray, computed tomography (CT) scan and positive sputum AFB stain results revealed that she had active pulmonary tuberculosis accompanying erythema nodosum and aseptic polyarthritis. Her arthritis and erythema nodosum were dramatically improved within four weeks after anti-tuberculosis therapy. We report a case of Poncet's disease in pulmonary tuberculosis accompanying erythema nodosum.

A Case of Peritoneal Tuberculosis with Poncet's Disease in a Patient Treated with Infliximab

Infliximab is a chimeric mouse/human monoclonal antibody against tumor necrosis factor-alpha (TNF-α) that is used worldwide to treat rheumatic disease. However, the reactivation of tuberculosis, including extrapulmonary menifestation, is a severe side effect of anti-TNF-α treatment. Mycobacterium tubercluosis causes two forms of joint involvement, TB arthritis and Poncet's disease. Poncet’s disease is a rare aseptic form of arthritis, known as reactive arthritis in tuberculosis. We encountered a case of tuberculous peritonitis with Poncet’s disease in a 38-yearold man with a history of ankylosing spondylitis that was treated with infliximab. We report this case with a review of the literature.

A Case of Poncet's Disease in a Patient with Pulmonary Tuberculosis

A Case of Poncet's Disease in a Patient with Pulmonary Tuberculosis

A case of Poncet disease diagnosed with interferon-γ-release assays

A 55-year-old, HLA-B27-positive Finnish woman presented with migratory, sterile polyarthritis. Physical examination, chest radiography, serologic testing, microscopy, M. tuberculosis-specific interferon gamma enzyme-linked immunospot (ELISPOT) assay, smear and culture of synovial fluid for acid-fast bacilli, and PCR. The patient's assayed blood and synovial fluid lymphocytes were reactive, and the numbers of M. tuberculosis-specific T cells, as determined by ELISPOT, were twofold to sixfold higher in synovial fluid than in blood. Cultures for acid-fast bacilli remained negative, while PCR specific for DNA of the M. tuberculosis complex was positive in synovial fluid cells. These results suggested that the patient had either active or latent M. tuberculosis infection. This finding, coupled with the presence of polyarthritis, led to a diagnosis of Poncet disease. Standard antituberculous therapy consisting of isoniazid, rifampicin and pyrazinamide was given for 2 months, followed by isoniazid and rifampicin for 4 months. Inflamed joints were treated with methylprednisolone injections. The polyarthritis resolved within 4 months of initiating antituberculous therapy.

Polyarthrite chronique et tuberculose

Tuberculosis may be difficult to diagnose because its presentation may be very misleading. Here is a report of Poncet's disease, which occurred in a 61-year-old man, and revealed recurrence of tuberculosis (pulmonary and spinal) 12 years after first episode. The patient recovered from his rheumatism with antibiotherapy against TB. Poncet's disease is a chronic rheumatism, in reaction to Mycobacterium tuberculosis that can occur even if the infection is in a latent form. Practitioners must know this disease, even if it's rare: tuberculosis is a differential diagnosis of chronic polyarthritis, especially in patients with risk factors.

A case of Poncet’s disease (tuberculous rheumatism)

We describe a 37-year-old woman with recurrent polyarthritis, and recurrent erythema nodosum on the flexible side of her left forearm. On an X-ray of the chest, infiltration of the right upper lobe was observed. Transcription-reverse transcription concerted reaction in sputum samples revealed Mycobacterium tuberculosis (M. tuberculosis). Resolution of the polyarthritis with anti-tuberculosis (TB) drugs occurred in 3 days. We diagnosed her with Poncet's disease (PD). PD is considered to be a reactive arthritis, which is a different entity from tuberculous arthritis. Although PD is a rare disease, we should be aware of it as one of the differential diagnoses, even in patients without typical symptoms of TB.

O28 Poncet's disease and Lofgren's syndrome in a rheumatology centre in North India, a preliminary comparative study

O28 Poncet's disease and Lofgren's syndrome in a rheumatology centre in North India, a preliminary comparative study

Poncet\'s Disease (Tuberculous Rheumatism) in a Nigerian Boy- Case Report

Poncet's disease or tuberculous rheumatism is an immunological reaction to mycobacteria tubercle with resultant reactive polyarthritis. Prompt distinction between Poncet's disease and tuberculous arthritis should be made because of the poor prognostic significance of tuberculous arthritis. In this paper, we report the case of a boy with Poncet's disease with prompt response to anti-tuberculous drugs.Nigerian Medical Practitioner Vol. 53 (3) 2008: pp. 26-27

Poncet's disease: reactive arthritis accompanying tuberculosis. Two case reports and a review of the literature

Reactive arthritis (ReA) in tuberculosis (TB) is known as Poncet's disease. It is a rare aseptic form of arthritis observed in patients with active TB. We present two such patients and review the literature on Poncet's disease. Two patients who were identified with Poncet's disease at the Department of Rheumatology of Erasmus MC, Rotterdam University Hospital, during the last 5 yrs are reported. In addition, a review of the literature on Poncet's disease is given: the PubMed/MEDLINE database was studied up to December 2005 using the term 'Poncet's disease' and the terms 'arthritis', 'reactive' and 'tuberculosis'. After careful work-up, the polyarthritis and erythema nodosum in both presented patients with active TB could be diagnosed as Poncet's disease. Resolution of the arthritis with anti-TB drugs occurred in just a few days. Reviewing the literature, 50 case reports were found. In most reports 'Poncet's disease' was described as an aseptic polyarthritis, presumably ReA arthritis developing in the presence of active TB elsewhere. However, no uniform characterization of the term 'Poncet's disease' could be abstracted from these reports. Both presented patients and the review of the literature demonstrate that active TB may be complicated by ReA known as Poncet's disease. Early recognition of this rare complication of TB is of major importance to avoid delayed initiation of appropriate treatment.