title: Poncet's disease (reactive arthritis associated with tuberculosis): retrospective case series and review of literature.
abstract: 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.
authors.affiliation: Rheumatology Unit, Department of Medicine, King Fahad Hospital, Jeddah, Saudi Arabia. drsabdulaziz@yahoo.com
authors.forename: Sultana
authors.initials: S
authors.lastname: Abdulaziz
authors.forename: Hani
authors.initials: H
authors.lastname: Almoallim
authors.forename: Ashraf
authors.initials: A
authors.lastname: Ibrahim
authors.forename: Mohammed
authors.initials: M
authors.lastname: Samannodi
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shabrawishi
authors.forename: Yasir
authors.initials: Y
authors.lastname: Meeralam
authors.forename: Ghadi
authors.initials: G
authors.lastname: Abdulmajeed
authors.forename: Ghadeer
authors.initials: G
authors.lastname: Banjar
authors.forename: Weam
authors.initials: W
authors.lastname: Qutub
authors.forename: Hiba
authors.initials: H
authors.lastname: Dowaikh
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D000995:Antitubercular Agents