[Tuberculous rheumatism "Poncet's disease". Case report]

Area of Science:

• Rheumatology
• Infectious Diseases
• Immunology

Background:

• Tuberculosis (TB) causes millions of deaths globally each year.
• Poncet's disease is an uncommon manifestation of TB presenting as polyarthritis.
• Distinguishing Poncet's disease from autoimmune inflammatory joint conditions poses a diagnostic challenge.

Observation:

• A 24-year-old male presented with symmetrical polyarthritis and lymphadenopathy.
• Laboratory tests showed elevated inflammatory markers but were negative for rheumatoid factor and anti-cyclic citrullinated peptide antibodies.
• Positive antinuclear antibodies were observed, initially suggesting an autoimmune condition.

Findings:

• Histological examination of lymph node tissue confirmed granulomatous lesions consistent with tuberculosis.
• Rheumatoid arthritis and systemic lupus erythematosus were excluded based on clinical and laboratory findings.
• Treatment with anti-tuberculosis agents led to complete resolution of the patient's joint symptoms.

Implications:

• This case highlights the importance of considering Poncet's disease in the differential diagnosis of inflammatory polyarthritis, especially in endemic areas.
• Accurate diagnosis is critical to initiate appropriate anti-tuberculosis therapy and avoid unnecessary immunosuppression.
• The clinical presentation of Poncet's disease underscores the diverse ways tuberculosis can manifest, posing diagnostic challenges for clinicians.