title: Bacillus Calmette-Guérin associated arthropathy mimicking undifferentiated spondyloarthropathy.
abstract: The development of an inflammatory arthritis mimicking an undifferentiated spondyloarthropathy (SpA) was seen in a patient being treated for a superficial bladder cancer with intravesical bacillus Calmette-Guérin (BCG). Physical findings included classic dactylitis of both feet. This is the fourth report identifying a patient with BCG induced articular findings suggestive of a SpA with dactylitis. Studies of BCG stimulated cytokine secretion from peripheral blood mononuclear cells showed the patient to have enhanced interleukin 6 (IL-6) levels and reduced interferon-gamma (IFN-gamma) levels. Spontaneous IL-6 secretion was markedly elevated for the patient, compared to the control subject, but IFN-gamma secretion was quite similar. No differences were apparent with IL-4.
authors.affiliation: Department of Medicine, University of Kansas Medical Center, Kansas City 66160, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Schwartzenberg
authors.forename: D D
authors.initials: DD
authors.lastname: Smith
authors.forename: H B
authors.initials: HB
authors.lastname: Lindsley
mesh_terms: D016918:Arthritis, Reactive / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D001500:BCG Vaccine / Q000009:adverse effects* / Q000627:therapeutic use; D002074:Butanones / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000628:therapy; D016207:Cytokines / Q000378:metabolism; D003937:Diagnosis, Differential; D004008:Diclofenac / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000077430:Nabumetone; D013167:Spondylitis, Ankylosing / Q000175:diagnosis*; D014033:Toe Joint; D001749:Urinary Bladder Neoplasms / Q000628:therapy
chemical_list: D001500:BCG Vaccine; D002074:Butanones; D016207:Cytokines; D005938:Glucocorticoids; D004008:Diclofenac; D000077430:Nabumetone