title: [Tuberculous rheumatism "Poncet's disease". Case report].
abstract: BACKGROUND
  Deaths due to tuberculosis have reached 2.5 million cases per year worldwide. Poncet's disease is an infrequent form of tuberculosis characterised by a clinical picture of polyarthritis.
  
  
  METHODS
  A 24-year-old male presented with morning stiffness, arthralgias, bilateral symmetric arthritis of the proximal interphalangeal joints, wrists, knees, ankles, and shoulders, and adenomegalies at the cervical, submandibular, left supraclavicular, axillary and inguinal levels, without fever. Laboratory results were as follows: ESR 44mm/h, C-reactive protein 4.35, normal levels of complement C3 and C4, negative rheumatoid factor and anticyclic citrullinated peptide antibodies, positive antinuclear antibodies with fine speckled pattern (1:320) and cytoplasm (1:160) pattern and negative anti-Smith, -double-stranded DNA, Sjogren's syndrome-antigen A and Sjogren's syndrome-antigen B. Histological report of cervical node tissue revealed granulomatous lesions compatible with tuberculosis. Rheumatoid arthritis and systemic lupus erythematosus were ruled out. Anti-tuberculosis agents were initiated that resolved the clinical picture. Diagnosis of Poncet's disease was confirmed.
  
  
  CONCLUSIONS
  The differential diagnosis between tuberculosis and autoimmune inflammatory joint diseases is a clinical challenge.
authors.affiliation: División de Medicina, Hospital Juárez de México, México, D.F., México. Electronic address: gelz1@prodigy.net.mx.
authors.forename: Gustavo Esteban
authors.initials: GE
authors.lastname: Lugo-Zamudio
authors.affiliation: Servicio de Reumatología, Hospital Juárez de México, México, D.F., México.
authors.forename: Rosa Elda
authors.initials: RE
authors.lastname: Barbosa-Cobos
authors.affiliation: Servicio de Reumatología, Hospital Juárez de México, México, D.F., México.
authors.forename: Laura Virginia
authors.initials: LV
authors.lastname: González-Ramírez
authors.affiliation: Laboratorio de Histocompatibilidad, Hospital Juárez de México, México, D.F., México.
authors.forename: Dolores
authors.initials: D
authors.lastname: Delgado-Ochoa
mesh_terms: D016918:Arthritis, Reactive / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D008297:Male; D012216:Rheumatic Diseases / Q000175:diagnosis / Q000382:microbiology; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis; D055815:Young Adult
keywords: Artritis reactiva; Enfermedad de Poncet; Poncet's disease; Reactive arthritis; Reumatismo tuberculoso; Tuberculosis; Tuberculous rheumatism