title: Poncet's disease: two case reports.
abstract: BACKGROUND
  One of the rare presentations of active pulmonary or even extrapulmonary tuberculosis is polyarthropathy which is the involvement of multiple large and small joints in the body; a reactive constellation known as Poncet's disease. This may sometimes be the sole manifestation of the disease before more obvious features develop. The pain experienced during polyarthritis can be crippling thereby limiting the mobility and activities of patients. Polyarthritis as a symptom of active tuberculosis can be easily misinterpreted for more common causes of polyarthritis such as rheumatological diseases that present similarly.
  
  
  METHODS
  We describe the case of a 25-year-old Asian woman and a 45-year-old Asian man who presented with active tuberculosis where polyarthralgia was the first and only symptom for many months followed by pulmonary and pleural manifestations. Both patients showed dramatic improvement with anti-tuberculous therapy. The total duration of therapy was 6 months.
  
  
  CONCLUSIONS
  Based on our observations, we propose that tuberculosis be included among the differentials for patients with unusual presentation of joint pains, especially in endemic regions and/or susceptible populations.
authors.affiliation: Aga Khan University Karachi, Karachi, Pakistan.
authors.forename: Fatima
authors.initials: F
authors.lastname: Adhi
authors.affiliation: Aga Khan University Karachi, Karachi, Pakistan.
authors.forename: Rabia
authors.initials: R
authors.lastname: Hasan
authors.affiliation: Aga Khan University Karachi, Karachi, Pakistan.
authors.forename: Mehreen
authors.initials: M
authors.lastname: Adhi
authors.affiliation: Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Syed Ali
authors.initials: SA
authors.lastname: Hamid
authors.affiliation: Department of Medicine, Section of Pulmonary and Critical Care, Aga Khan University, Stadium Road, Karachi, Pakistan. nousheen.iqbal@aku.edu.
authors.forename: Nousheen
authors.initials: N
authors.lastname: Iqbal
authors.affiliation: Department of Medicine, Section of Pulmonary and Critical Care, Aga Khan University, Stadium Road, Karachi, Pakistan.
authors.forename: Javaid A
authors.initials: JA
authors.lastname: Khan
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016918:Arthritis, Reactive / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D044466:Asian People; D005260:Female; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014374:Tuberculin Test; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000995:Antitubercular Agents
keywords: Poncet’s disease; Tuberculosis; Tuberculous rheumatism; polyarthritis