Reactive Arthritis – A Rare Complication of Intravesical BCG Instillation

Abstract

Reactive arthritis (ReA) with the classic triad of arthritis, conjunctivitis and urethritis, previously termed Reiter’s syndrome, is a systemic illness, usually induced by genitourinary or gastrointestinal infections. However, it can be a rare complication of intravesical Bacillus Calmette-Guérin instillation (iBCG), a therapy prepared from attenuated strains of Mycobacterium bovis, a common and effective treatment for carcinoma in situ of the bladder (CisB). We report a case of a patient with CisB who developed ReA after iBCG. The symptoms resolved completely with corticosteroids. iBCG was stopped with no recurrence of carcinoma within 2 years.

Uncommon adverse events of intravesical Bacillus Calmette-Guérin treatment: A report of three cases

“…It has a favorable course and vast majority of cases can be successfully treated with NSAID monotherapy, corticosteroid monotherapy or in combination. It is reported that joint symptoms last about within two months and fully recover (93.2%) within six months [8]. Consistently with the literature our case was presented with oligo-arthritis involving knee, ankle and small hand joints, and he was successfully treated with NSAID and steroid combination.…”

“…Arthritis is a rare complication of BCG treatment. Reported prevalence is variable, ranging between 0.5% and 3.6% [8]. Polyarthritis is the most common clinical presentation that can be symmetric or asymmetric with similar prevalence.…”

“…Polyarthritis is the most common clinical presentation that can be symmetric or asymmetric with similar prevalence. Mono-oligoarthritis is less common seen and tend to be in asymmetric pattern [8]. Knee and ankle are the most effected joints.…”