Reactive Arthritis following Bacillus Calmette–Guerin Therapy for Bladder Cancer: a Systematic Literature Review

Abdelghani, Kawther Ben; Nacef, L.; Miladi, S.; Sellami, Mokhtar; Ouenniche, K.; Souabni, L.; Kassab, S.; Chékili, S.; Fazaa, A.; Laatar, A.

doi:10.1007/s11926-021-01004-y

Cited by 6 publications

(12 citation statements)

References 31 publications

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“…Interestingly, Chlamydia serology when done in these patients yielded negative results universally indicating a lack of pathophysiological synchrony with Chlamydia in patients who develop ReA following BCG therapy 8…”

Section: Discussionmentioning

confidence: 94%

“…Although the overall prevalence of HLA B27 in ReA patients ranges from 50%–80%, the prevalence of HLA in BCG associated Re A has been found out to be much lower (29%) 8. It is a known fact that B27 is not a diagnostic tool for acute ReA as it has low predictive value.…”

Section: Discussionmentioning

confidence: 99%

“…In a review by Abdelghani et al, joint pain was the most frequently reported symptom (100%), followed by fever (81%) 8. Extra-articular manifestations like urethritis and/or balanitis (35%) cystitis (27%–95%), conjunctivitis (64%) have also been described in a proportion of patients 8…”

Section: Discussionmentioning

confidence: 99%

“…Most patients recover with NSAID monotherapy (49.4%) with few requiring additional glucocorticoids (10.3% with NSAIDS; 21.8% alone)2 Usual time of resolution is within 6 months, however, for a prolonged disease course, DMARDS may be warranted 2. However, in pan-resistant cases, proposal of isoniazid or rifampicin have been mentioned in the literature but as use of the above drugs can result in loss of efficacy of iBCG, hence their use remains controversial 2 8…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…4 It is frequently self-limited, occurring typically after a mean of 5.7 instillations of BCG. 5 Axial involvement with inflammatory back pain was reported in 19% of patients with BCG ReA. 4 In addition, extra-articular manifestations, such as fever, conjunctivitis, or uveitis, may also be present in one-third of the cases.…”

Section: Discussionmentioning

confidence: 99%

Reactive arthritis as a rare complication of intravesical bacillus Calmette–Guérin treatment: Report of two cases

et al. 2023

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Intravesical bacillus Calmette–Guérin (BCG) immunotherapy is recommended for non‐muscle‐invasive bladder cancer after transurethral resection. BCG‐associated musculoskeletal adverse events are rare. We report two cases of BCG reactive arthritis that were unusually severe and refractory. These describe two male patients who presented with polyarthritis after BCG exposure. Ultrasonography‐guided glucocorticoid injections, high‐dose systemic glucocorticoids and the institution of sulfasalazine were required for achievement of remission. Bacillus Calmette–Guérin reactive arthritis can present as polyarthritis of small and medium joints or as mono‐oligoarthritis of asymmetrical ankles and knees, frequently associated with tenosynovitis and enthesitis. The mechanism by which BCG promotes arthralgia and arthritis is poorly understood. The most well‐accepted theory is that the BCG antigens migrate to different peripheral tissues, including the joints. There is also a lack of knowledge regarding risk factors, with possible genetic factors playing a role. As the two presented cases show, BCG‐induced reactive arthritis should be considered in the differential diagnosis of arthritis and refractory tenosynovitis in BCG‐exposed patients.

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BCG and Autoimmunity

Dogan,

Deniz,

Dogru

et al. 2024

Infection and Autoimmunity

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Reactive Arthritis following Bacillus Calmette–Guerin Therapy for Bladder Cancer: a Systematic Literature Review

Cited by 6 publications

References 31 publications

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

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

Reactive arthritis as a rare complication of intravesical bacillus Calmette–Guérin treatment: Report of two cases

BCG and Autoimmunity

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