Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Apr 13;15(4):e249208.
doi: 10.1136/bcr-2022-249208.

Reactive arthritis following treatment with intravesical Bacillus Calmette-Guerin for papillary carcinoma of bladder

Yogesh Preet Singh  1 , Debaditya Roy  2 , Bhargavi Jois  3 , Mohit Shetti  4
Affiliations
Case Reports

Reactive arthritis following treatment with intravesical Bacillus Calmette-Guerin for papillary carcinoma of bladder

Yogesh Preet Singh et al. BMJ Case Rep. .

Abstract

A man in his 60s developed reactive arthritis following treatment with intravesical Bacillus Calmette-Guerin (iBCG) for papillary carcinoma of bladder. Evaluation revealed leucocytosis and raised inflammatory markers. HLA B27 was positive. Based on the temporal relationship, it was attributed to BCG-related reactive arthritis. iBCG was stopped. Treatment with non-steroidal anti-inflammatory drugs (NSAIDS) and glucocorticoids were ineffective. Prolonged course of disease-modifying antirheumatic drugs (DMARDS) was required which aided in alleviation of symptoms and sustained remission. Intravesical BCG therapy is a treatment for bladder cancer. It is rarely associated with reactive arthritis, which responds to discontinuation of iBCG and treatment with NSAIDS and/or short-term glucocorticoids. iBCG-related reactive arthritis commonly has an acute/subacute course. Chronic arthritis as observed in our case requiring prolonged treatment with DMARDS is rare.

Keywords: Drugs and medicines; Musculoskeletal and joint disorders; Rheumatology; Unwanted effects / adverse reactions; Urological cancer.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose with computed tomography scan (F18-FDG PET-CT) shows physiological FDG uptake in the brain, vocal cords, myocardium, liver, kidneys, intestine and urinary bladder; no abnormal metabolic activity suggesting local recurrence or metastasis. Also seen is increased metabolic activity in periarticular region in the shoulder joints bilaterally (black arrows) and in the left first metacarpophalangeal joint (orange arrows).
See this image and copyright information in PMC

References

    1. García-Kutzbach A, Chacón-Súchite J, García-Ferrer H, et al. . Reactive arthritis: update 2018. Clin Rheumatol 2018;37:869–74. 10.1007/s10067-018-4022-5 - DOI - PubMed
    1. Bernini L, Manzini CU, Giuggioli D, et al. . Reactive arthritis induced by intravesical BCG therapy for bladder cancer: our clinical experience and systematic review of the literature. Autoimmun Rev 2013;12:1150–9. 10.1016/j.autrev.2013.06.017 - DOI - PubMed
    1. Ben Abdelghani K, Fazaa A, Souabni L. Reactive arthritis induced by intravesical BCG therapy for bladder cancer. BMJ Case Rep 2014. - PMC - PubMed
    1. Tinazzi E, Ficarra V, Simeoni S, et al. . Reactive arthritis following BCG immunotherapy for urinary bladder carcinoma: a systematic review. Rheumatol Int 2006;26:481–8. 10.1007/s00296-005-0059-2 - DOI - PubMed
    1. Taniguchi Y, Nishikawa H, Karashima T, et al. . Frequency of reactive arthritis, uveitis, and conjunctivitis in Japanese patients with bladder cancer following intravesical BCG therapy: a 20-year, two-centre retrospective study. Joint Bone Spine 2017;84:637–8. 10.1016/j.jbspin.2016.09.014 - DOI - PubMed

Publication types

MeSH terms