Evidence map›Paper›PMID 42484251›Full record

ArticleRevista do Instituto de Medicina Tropical de Sao Paulo2026

Disseminated tuberculosis with Poncet's disease mimicking childhood-onset systemic lupus erythematosus: a unique case report.

Matheus Santos França, Fernanda Lima Gomes, Marina de Azambuja Nogueira, Maria Fernanda Bádue Pereira, Heloisa Helena de Sousa Marques, Katia Tomie Kozu, Lucia Maria Arruda Campos, Clovis Artur Silva

Abstract readCase Reports
In one paragraph

Article in Revista do Instituto de Medicina Tropical de Sao Paulo, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Matheus Santos FrançaUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Unidade de Reumatologia Pediátrica, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0009-0009-5430-0088
Fernanda Lima GomesUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Unidade de Infectologia Pediátrica, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0001-7616-9898
Marina de Azambuja NogueiraUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Unidade de Infectologia Pediátrica, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0009-0009-8689-8715
Maria Fernanda Bádue PereiraUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Unidade de Infectologia Pediátrica, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0001-8844-8245
Heloisa Helena de Sousa MarquesUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Unidade de Infectologia Pediátrica, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-0940-7793
Katia Tomie KozuUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Unidade de Reumatologia Pediátrica, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0001-8743-7827
Lucia Maria Arruda CamposUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Unidade de Reumatologia Pediátrica, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0001-9653-0468
Clovis Artur SilvaUniversidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Unidade de Reumatologia Pediátrica, São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0001-9250-6508

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Disseminated tuberculosis in children may present with systemic and immunologic features that overlap with autoimmune diseases, complicating diagnosis and treatment. We report the first pediatric case of microbiologically confirmed disseminated tuberculosis involving multiple sites associated with Poncet's disease, mimicking childhood-onset systemic lupus erythematosus (cSLE). A previously healthy five-year-old boy presented with a four-month history of persistent fever, weight loss, and symmetrical oligoarthritis involving both knees and wrists, resulting in loss of mobility. Laboratory tests revealed severe non-hemolytic anemia, leukopenia, elevated inflammatory markers, hypoalbuminemia, hematuria, positive antinuclear antibodies, low complement levels, and lupus anticoagulant positivity. Chest imaging showed bilateral pleural effusion, pulmonary opacities, and lymphadenopathy, fulfilling the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for cSLE. Despite initially negative tuberculin skin test and gastric lavage analysis, lymph node biopsy confirmed Mycobacterium tuberculosis by histology, molecular assay, and culture. Subsequent urine and gastric samples were also positive. The patient had received BCG vaccination at birth. He was treated with rifampicin, isoniazid, pyrazinamide, and pyridoxine, with rapid clinical improvement, complete resolution of arthritis, and full recovery of mobility without sequelae in one month. No immunosuppressive therapy was administered. This case reinforces the diagnostic complexity of distinguishing tuberculosis from childhood-onset systemic autoimmune rheumatic diseases, particularly in endemic regions. To our knowledge, this is the first reported pediatric case of disseminated tuberculosis with Poncet's disease mimicking cSLE. Recognizing this specific condition is crucial to prevent misdiagnosis and unnecessary immunosuppression, while ensuring timely treatment of the underlying infection.

Indexed as

Arthritis, ReactiveLupus Erythematosus, SystemicAntitubercular AgentsChild, PreschoolDiagnosis, DifferentialHumansMaleAntitubercular Agents

Identifiers

PMID42484251
PMCPMC13384502

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.