Poncet's Disease in Human Immunodeficiency Virus: a Case Report

Overview

Journal BMC Res Notes

Publisher Biomed Central

Specialties Biology
General Medicine

Date 2017 Jun 14

PMID 28606166

Authors

Enoch Omonge

Fredrick Otieno

Mary Kubo

Betty Shiruli

Affiliations

Soon will be listed here.

Abstract

Background: Poncet's disease is a rare reactive polyarthritis associated with active tuberculosis and no evidence of Mycobacterium tuberculosis in the affected joint.

Case Presentation: We report a case of a 35 year old Human Immunodeficiency Virus positive Kenyan male of Kikuyu ethnicity from Kiambu County who presented to hospital with a 6 day history of bilateral knee pain and swelling, bilateral ankle pain with right ankle swelling. The patient reported 6 months history of cough and weight loss. Chest radiograph had features consistent with pulmonary tuberculosis and sputum smear was positive for acid fast bacilli. Analysis of fluid from knee effusion showed no evidence of tuberculosis. Resolution of joint swelling was seen after 3 weeks of tuberculosis chemotherapy suggesting that this was reactive arthritis following pulmonary tuberculosis in a patient infected with human immunodeficiency virus.

Conclusion: This case represents a rare manifestation of tuberculosis presenting as a reactive arthritis. There are very few cases of Poncet's disease reported in literature and the diagnosis of Poncet's disease in Human Immunodeficiency Virus/tuberculosis coinfected patient is extremely uncommon. This case report has been presented to raise awareness of this unusual tuberculosis complication and review its diagnosis and treatment.

References

Malaviya A, Kotwal P . Arthritis associated with tuberculosis. Best Pract Res Clin Rheumatol. 2003; 17(2):319-43. DOI: 10.1016/s1521-6942(02)00126-2. View

Tikly M, Njobvu P, McGill P . Spondyloarthritis in sub-Saharan Africa. Curr Rheumatol Rep. 2014; 16(6):421. DOI: 10.1007/s11926-014-0421-z. View

Lesprit P, Lafaurie M, Liote F, Decazes J, Modai J . Tuberculous rheumatism (Poncet's disease) in a patient infected with human immunodeficiency virus. Clin Infect Dis. 1996; 23(5):1179-80. DOI: 10.1093/clinids/23.5.1179. View

Pattamapaspong N, Muttarak M, Sivasomboon C . Tuberculosis arthritis and tenosynovitis. Semin Musculoskelet Radiol. 2011; 15(5):459-69. DOI: 10.1055/s-0031-1293492. View

Ottenhoff T, Torres P, De las Aguas J, Fernandez R, van Eden W, de Vries R . Evidence for an HLA-DR4-associated immune-response gene for Mycobacterium tuberculosis. A clue to the pathogenesis of rheumatoid arthritis?. Lancet. 1986; 2(8502):310-3. DOI: 10.1016/s0140-6736(86)90004-8. View

Bloch A, Rieder H, Kelly G, Cauthen G, Hayden C, Snider Jr D . The epidemiology of tuberculosis in the United States. Implications for diagnosis and treatment. Clin Chest Med. 1989; 10(3):297-313. View

Kingsley G . Reactive arthritis: a paradigm for inflammatory arthritis. Clin Exp Rheumatol. 1993; 11 Suppl 8:S29-36. View

Southwood T, Gaston J . The molecular basis of Poncet's disease?. Br J Rheumatol. 1990; 29(6):491. DOI: 10.1093/rheumatology/29.6.491. View

Schweitzer L, Lipnharski F, Prezzi S . Poncet's arthritis: case report. Rev Bras Reumatol. 2011; 51(4):388-90, 393. View

10.

Adizie T, Moots R, Hodkinson B, French N, Adebajo A . Inflammatory arthritis in HIV positive patients: A practical guide. BMC Infect Dis. 2016; 16:100. PMC: 4774153. DOI: 10.1186/s12879-016-1389-2. View

11.

Dall L, Long L, Stanford J . Poncet's disease: tuberculous rheumatism. Rev Infect Dis. 1989; 11(1):105-7. DOI: 10.1093/clinids/11.1.105. View

12.

Kasivisvanathan V, Connell D, Molyneaux P, Singanayagam A, George P, Tench C . A presentation of Poncet's disease identified following immunosuppressive steroid therapy. Int J Tuberc Lung Dis. 2012; 16(5):708-9. DOI: 10.5588/ijtld.11.0749. View

13.

van Eden W, de Vries R, Stanford J, Rook G . HLA-DR3 associated genetic control of response to multiple skin tests with new tuberculins. Clin Exp Immunol. 1983; 52(2):287-92. PMC: 1535848. View

14.

Lugo-Zamudio G, Yamamoto-Furusho J, Delgado-Ochoa D, Nunez-Farfan R, Vargas-Alarcon G, Barbosa-Cobos R . Human leukocyte antigen typing in tuberculous rheumatism: Poncet's disease. Int J Tuberc Lung Dis. 2010; 14(7):916-20. View

15.

Kroot E, Hazes J, Colin E, Dolhain R . Poncet's disease: reactive arthritis accompanying tuberculosis. Two case reports and a review of the literature. Rheumatology (Oxford). 2006; 46(3):484-9. DOI: 10.1093/rheumatology/kel268. View

16.

Colmegna I, Espinoza L . Recent advances in reactive arthritis. Curr Rheumatol Rep. 2005; 7(3):201-7. DOI: 10.1007/s11926-996-0040-4. View