title: Reiter's syndrome following intravesical bacille biliE de Calmette-GuErin treatment for superficial bladder carcinoma: report of six cases.
abstract: We report the cases of six patients who developed acute Reiter's syndrome following intravesical bacille biliE de Calmette-GuErin (BCG) immunotherapy for superficial bladder cancer. After the third to eighth BCG intravesical injection, the patients developed conjunctivitis, aseptic urethritis, and polyarthritis consistent with a diagnosis of Reiter's syndrome. HLA-B27 antigen was negative in five of the patients examined. Two of the patients responded to nonsteroidal anti-inflammatory drugs for polyarthritis, and the other four responded to steroids (prednisolone 5-10 mg/day). The frequent use of intracavitary BCG may increase the incidence of BCG-induced Reiter's syndrome. Further analysis of the relationship between HLA-B and -DR alleles and arthritis should shed light on the mechanism of BCG-induced Reiter's syndrome.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan, tsumida@md.tsukuba.ac.jp.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Murata
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Adachi
authors.forename: Takehiko
authors.initials: T
authors.lastname: Ebitsuka
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Chino
authors.forename: Reiko
authors.initials: R
authors.lastname: Takahashi
authors.forename: Taichi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Goto
authors.forename: Isao
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Akito
authors.initials: A
authors.lastname: Tsutsumi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Akaza
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sumida