Renal complications of intravesical bacillus Calmette-Guérin therapy.
We report 3 patients who developed signs of systemic infection and renal insufficiency after intravesical bacillus Calmette-Guérin (BCG) instillations for a bladder cancer. Renal biopsy showed tubulo-interstitial nephritis with or without epithelioid granulomas in 2 cases, and mesangial glomerulonephritis in the last case. All patients had granulomatous hepatitis in association. It seems that hematogenous dissemination via a traumatic instillation of BCG and/or an immune-complex mechanism may have contributed to the renal damage, which was only partially reversible in 2 patients.
Modesto
A
A
Department of Immunology, University of Rangueil, Toulouse, France.
Marty
L
L
Suc
J M
JM
Kleinknecht
D
D
de Frémont
J F
JF
Marsepoil
T
T
Veyssier
P
P
D000283:Administration, Intravesical; D000368:Aged; D001500:BCG Vaccine / Q000009:adverse effects* / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000628:therapy; D005921:Glomerulonephritis / Q000209:etiology; D006099:Granuloma / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D008107:Liver Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000209:etiology; D010212:Papilloma / Q000628:therapy; D001749:Urinary Bladder Neoplasms / Q000628:therapy
D001500:BCG Vaccine