Disseminated Pulmonary Granulomas after Intravesical Bacillus Calmette-Guérin Immunotherapy

Diego, A. De; Rogado, M.C.; Prieto, Mireya; Nauffal, Dolores; Perpiñá, M.

doi:10.1159/000196693

Cited by 13 publications

(6 citation statements)

References 12 publications

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“…146 Third, a DISR should be differentiated from acute granulomatous interstitial lung disease from methotrexate [148][149][150] and acute pulmonary granulomatosis with alveolar damage from intracavitary Bacillus Calmette-Guérin therapy. 151,152 These are isolated pulmonary toxicities, which are usually progressive, and may result in respiratory failure from pulmonary compromise. Finally, because many of the drugs associated with DISRs are injectable agents, a foreign body granulomatous reaction at an injection site leiomyosarcoma.…”

Section: Clinical Definition Of a Disrmentioning

confidence: 99%

Drug-Induced Sarcoidosis-Like Reactions

Chopra

Nautiyal

Kalkanis

et al. 2018

Chest

149

139

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A drug-induced sarcoidosis-like reaction (DISR) is a systemic granulomatous reaction that is indistinguishable from sarcoidosis and occurs in a temporal relationship with initiation of an offending drug. DISRs typically improve or resolve after withdrawal of the offending drug. Four common categories of drugs that have been associated with the development of a DISR are immune checkpoint inhibitors, highly active antiretroviral therapy, interferons, and tumor necrosis factor-α antagonists. Similar to sarcoidosis, DISRs do not necessarily require treatment because they may cause no significant symptoms, quality of life impairment, or organ dysfunction. When treatment of a DISR is required, standard antisarcoidosis regimens seem to be effective. Because a DISR tends to improve or resolve when the offending drug is discontinued, this is another effective treatment for a DISR. However, the offending drug need not be discontinued if it is useful, and antigranulomatous therapy can be added. In some situations, the development of a DISR may suggest a beneficial effect of the inducing drug. Understanding the mechanisms leading to DISRs may yield important insights into the immunopathogenesis of sarcoidosis.

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Section: Clinical Definition Of a Disrmentioning

confidence: 99%

Drug-Induced Sarcoidosis-Like Reactions

Chopra

Nautiyal

Kalkanis

et al. 2018

Chest

149

139

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“…Within a few weeks of completing a course of therapy with intravesical BCG, patient 1 developed BCG infection, which progressed in a manner similar to that of disseminated tuberculosis until antituberculous therapy was given. Although many noncaseating granulomas were seen on histologic examination, culture results were negative for M. bovis, a finding that has led some observers to emphasize the role of hypersensitivity as the cause of symptoms [12][13][14][15][16][17][18]; this concept derives support from the rapidity and completeness of the response to only 6 weeks of therapy. The response to treatment is also consistent with the idea that host immunity may become effective once treatment is given for infection caused by a pathogen with relatively low-grade virulence.…”

Section: Summary Of Data From Our 8 Casesmentioning

confidence: 99%

Spectrum of Bacille Calmette‐Guerin (BCG) Infection after Intravesical BCG Immunotherapy

González¹,

et al. 2003

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Intravesical instillation of bacille Calmette-Guérin (BCG) effectively treats transitional cell carcinoma of the bladder. Occasionally, BCG infection complicates such treatment. In some patients, infection appears early (within 3 months after instillation) and is characterized by generalized symptoms, with pneumonitis and hepatitis. Late-presentation disease occurs >1 year after the first BCG treatment and usually involves focal infection of the genitourinary tract (the site at which bacteria were introduced) and/or other sites that are typical for reactivation of mycobacterial disease, such as the vertebral spine or the retroperitoneal tissues. Noncaseating granulomas are found in the majority of cases, whether early or late. Most patients respond to treatment with antituberculous drugs; in early-presentation disease, when features of hypersensitivity predominate, glucocorticosteroids are sometimes added. Late localized infection often requires surgical resection.

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“…Granulomatous lung disease can be caused by various agents such as interferon- γ therapy for chronic hepatitis or multiple sclerosis [15, 16]; methotrexate or TNF- α blocking agent for autoimmune disease [17–19]; BCG [20]; and some antineoplastic drugs including everolimus or gefitinib [21]. However a sarcoidosis reaction complicated by FOLFOX chemotherapy has never been reported previously.…”

Section: Discussionmentioning

confidence: 99%

Sarcoidosis Associated with Oxaliplatin-Based Chemotherapy for Colorectal Cancer

Choi

Shin

Park

et al. 2014

Case Reports in Oncological Medicine

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Acute lung injury occasionally occurs after chemotherapy, but pulmonary toxicities by oxaliplatin-based chemotherapy have rarely been identified. A 76-year-old female with rectosigmoid colon cancer presented with ongoing dyspnea after the eighth cycle of standard chemotherapy (5-fluorouracil, sodium folinic acid, and oxaliplatin: FOLFOX). Nodular consolidation progressed despite antibiotics and BAL fluid analysis was compatible with the diagnosis of sarcoidosis. Corticosteroid therapy rapidly improved the symptoms and radiographic findings. We report this first case of secondary sarcoidosis related to FOLFOX therapy with review of references.

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Disseminated Pulmonary Granulomas after Intravesical Bacillus Calmette-Guérin Immunotherapy

Cited by 13 publications

References 12 publications

Drug-Induced Sarcoidosis-Like Reactions

Drug-Induced Sarcoidosis-Like Reactions

Spectrum of Bacille Calmette‐Guerin (BCG) Infection after Intravesical BCG Immunotherapy

Sarcoidosis Associated with Oxaliplatin-Based Chemotherapy for Colorectal Cancer

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