[Dactilitis and oligoarthritis after BCG immunotherapy in a patient affected by bladder cancer].
The treatment of bladder cancer with Bacillus of Calmette-Guerin (BCG) immunotherapy can induce the appearance of a reactive disorder. The Authors describe a 55-year-old male patient with bladder cancer treated with endovesical instillation of BCG immunotherapy, followed after the fifth application by asymmetric oligoarthritis and dactilitis. The observed positivity of both HLA-B27 and HLA-B51 antigens reinforces the hypothesis of a reactive form, possibly through "molecular mimicry" mechanism. The discontinuation of BCG instillation along which a therapeutic attempt with NSAD failed to improve the rheumatic manifestation, which completely remitted after a four-month course of oral steroids. No relapses of joint and tendon involvement was observed during the following five-month period. The clinico-pathogenetic implications suggested by this case are discussed.
Manzini
C U
CU
Cattedra e Servizio di Reumatologia, Azienda Policlinico, Modena, Italia. manzini.carlo@policlinico.mo.it
Bernini
L
L
Elkhaldi
N
N
Mascia
M T
MT
Ferri
C
C
D000283:Administration, Intravesical; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016918:Arthritis, Reactive / Q000188:drug therapy* / Q000209:etiology*; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D002295:Carcinoma, Transitional Cell / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D016233:Immunotherapy, Active / Q000009:adverse effects*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D001500:BCG Vaccine; D008775:Methylprednisolone