J Rheum Dis.  2011 Mar;18(1):55-59. 10.4078/jrd.2011.18.1.55.

A Case of Peritoneal Tuberculosis with Poncet's Disease in a Patient Treated with Infliximab

• Park H
• Park CW
• Kim KB
• Lee MJ
• Zeon SJ
• Shim SC
• Lim MK
• Sheen DH

• KMID: 2223184
• DOI: http://doi.org/10.4078/jrd.2011.18.1.55

Abstract

Infliximab is a chimeric mouse/human monoclonal antibody against tumor necrosis factor-alpha (TNF-alpha) that is used worldwide to treat rheumatic disease. However, the reactivation of tuberculosis, including extrapulmonary menifestation, is a severe side effect of anti-TNF-alpha treatment. Mycobacterium tubercluosis causes two forms of joint involvement, TB arthritis and Poncet's disease. Poncet's disease is a rare aseptic form of arthritis, known as reactive arthritis in tuberculosis. We encountered a case of tuberculous peritonitis with Poncet's disease in a 38-yearold man with a history of ankylosing spondylitis that was treated with infliximab. We report this case with a review of the literature.

MeSH Terms

Antibodies, Monoclonal
Arthritis
Arthritis, Reactive
Humans
Joints
Mycobacterium
Peritonitis, Tuberculous
Rheumatic Diseases
Spondylitis, Ankylosing
Tuberculosis
Tumor Necrosis Factor-alpha
Infliximab
Antibodies, Monoclonal
Tumor Necrosis Factor-alpha

Figure

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  Figure 1. Simple pelvic X-ray. Near complete fusion with sacroiliitis can be seen in the both sacroiliac joints with post-status of total hip replacement surgery at the left hip joint.

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  Figure 2. Whole body bone scan. Increased uptake lesions can be seen in the both elbows, wrists, knees and ankles.

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  Figure 3. Contrast-enhanced abdominal computed tomography. (A) Massive ascites, diffuse omental infiltration and multifocal peritoneal thickening with enhancement, suggesting peritoneal tuberculosis in the abdomen CT. (B) The ascites disappeared and there was marked improvement in the multiple omental nodules and peritoneal thickening.

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