Acute eosinophilic pneumonia associated with intravesical bacillus Calmette-Guérin therapy of carcinoma in situ of the bladder.
A 71-year-old man with a history of rheumatoid arthritis was treated with intravesical bacillus Calmette-Guérin (BCG) instillation of 80 mg once-a-week for carcinoma in situ. He developed low-grade fever followed by dyspnea and severe hypoxemia. Radiological and laboratory studies revealed bilateral diffuse reticulonodular infiltrates and hypereosinophilia. A lymphocyte stimulation test for BCG was strongly positive. From these findings, a pulmonary hypersensitivity reaction to immunotherapy was suspected, and therefore, methylprednisolone (500 mg per day) was started. After that, the fever and dyspnea disappeared, the hypereosinophilia was normalised and chest radiography results were clear. The present case is the first reported case of eosinophilic pneumonia following intravesical BCG therapy.
Orikasa
Kazuhiko
K
Departments of Urology, Tohoku Rosai Hospital, Dainohara, Sendai, Japan. korikasa@bc4.so-net.ne.jp
Namima
Takashige
T
Ota
Shozo
S
Miura
Motohiko
M
Hama
Hikaru
H
Kimura
Noriko
N
Ohnuma
Tetsutaro
T
D000208:Acute Disease; D000276:Adjuvants, Immunologic / Q000008:administration & dosage* / Q000009:adverse effects*; D000283:Administration, Intravesical; D000368:Aged; D001500:BCG Vaccine / Q000008:administration & dosage* / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008297:Male; D011657:Pulmonary Eosinophilia / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
D000276:Adjuvants, Immunologic; D001500:BCG Vaccine