Journal List > J Korean Rheum Assoc > v.17(2) > 1003721

Park, Yun, Kang, Lee, Lee, Lee, and Song: A ase of Poncet's Disease in a Patient with Pulmonary Tuberculosis

Abstract

Since 1897 when Poncet first described polyarthritis in the acute stage of extra-articular tuberculosis, Poncet's disease has been considered a reactive arthritis to Mycobacterium tuberculosis. It is characterized by polyarthritis without evidence of direct mycobacterial involvement in patients with active tuberculosis, and eventually resolves without residual joint damage. Even though Poncet's disease is uncommon, the distinction between Poncet's disease and other arthritis, including tuberculous arthritis is clinically important. We report the second case of Poncet's disease diagnosed in a patient with pulmonary tuberculosis in Korea and review the relevant literature.

REFERENCES

1). Dall L., Long L., Stanford J. Poncet's disease: tuberculous rheumatism. Rev Infect Dis. 1989. 11:105–7.
crossref
2). Kroot EJ., Hazes JM., Colin EM., Dolhain RJ. Poncet's disease: reactive arthritis accompanying tuberculosis. Two case reports and a review of the literature. Rheumatology (Oxford). 2007. 46:484–9.
crossref
3). Lee HL., Lee IH., Son BK., Jung JH., Kim TH., Yang SC, et al. A case of Poncet's disease with tuberculosis of the intestine and lymph nodes. Korean J Med. 2001. 61:211–4.
4). Maricic MJ., Alepa FP. Reactive arthritis after Mycobacterium avium-intracellulare infection: Poncet's disease revisited. Am J Med. 1990. 88:549–50.
crossref
5). Hughes RA., Allard SA., Maini RN. Arthritis associated with adjuvant mycobacterial treatment for carcinoma of the bladder. Ann Rheum Dis. 1989. 48:432–4.
crossref
6). Toivanen A., Toivanen P. Reactive arthritis. Best Pract Res Clin Rheumatol. 2004. 18:689–703.
crossref
7). Kawsar M., D'Cruz D., Nathan M., Murphy M. Poncet's disease in a patient with AIDS. Rheumatology (Oxford). 2001. 40:346–7.
crossref
8). Southwood TR., Gaston JS. The molecular basis of Poncet's disease? Br J Rheumatol. 1990. 29:491.
crossref
9). van Eden W., Holoshitz J., Nevo Z., Frenkel A., Klajman A., Cohen IR. Arthritis induced by a T-lymphocyte clone that responds to Mycobacterium tuberculosis and to cartilage proteoglycans. Proc Natl Acad Sci USA. 1985. 82:5117–20.
crossref
10). van Eden W., de Vries RR., Stanford JL., Rook GA. HLA-DR3 associated genetic control of response to multiple skin tests with new tuberculins. Clin Exp Immunol. 1983. 52:287–92.
11). Ottenhoff TH., Torres P., de las Aguas JT., Fernandez R., van Eden W., de Vries RR, et al. Evidence for an HLA-DR4-associated immune-response gene for Mycobacterium tuberculosis. A clue to the pathogenesis of rheumatoid arthritis? Lancet. 1986. 2:310–3.
crossref
12). The Lancet. Immune reactions in tuberculosis. Lancet. 1984. 2:204.
13). Simcock DE., Mukherjee D., Gendi NS. Poncet's disease–a novel cause of non-compliance with anti-tuberculous drugs. Respir Med. 2004. 98:795–7.
crossref

Table 1.
Comparison between previously reported foreign and Korean cases of Poncet's disease
Foreign cases (2) Lee et al (3) Current case
Sex Male : Female 29 : 21 Female Male
Age (year old) Mean 28.8 (range 2~78) 26 51
Tuberculosis Pulmonary 52% (26/50)
Extra-pulmonary 48% (24/50)
Supraclavicular Lymph node and ileocecal area Pulmonary
Pattern of arthritis Polyarticular 70% (35/50)
Oligoarticular 30% (15/50)
Polyarticular Polyarticular
Sites of arthritis
Shoulder 21.4% (9/42) +
Elbow 38.1% (16/42)
Wrist 50.0% (21/42) +
Hand 26.2% (11/42) +
Hip 2.4% (1/42)
Knee 64.3% (27/42) + +
Ankle 57.1% (24/42) +
Foot 11.9% (5/42) +
Sacroiliac 4.8% (2/42)
Erythema nodosum 6% (3/50) Yes No
Resolution of arthritis after anti-tuberculous drugs 1 week~4 months Not described Within 4 months
TOOLS
Similar articles