Reiter's syndrome following intravesical bacille biliE de Calmette-GuErin treatment for superficial bladder carcinoma: report of six cases.
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.
Murata
Hideyuki
H
Division of Rheumatology, Department of Internal Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan, tsumida@md.tsukuba.ac.jp.
Adachi
Yoshihiro
Y
Ebitsuka
Takehiko
T
Chino
Yusuke
Y
Takahashi
Reiko
R
Hayashi
Taichi
T
Goto
Daisuke
D
Matsumoto
Isao
I
Tsutsumi
Akito
A
Akaza
Hideyuki
H
Sumida
Takayuki
T