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Case Reports: Adverse drug reactions and complications
Reactive arthritis following treatment with intravesical Bacillus Calmette-Guerin for papillary carcinoma of bladder
  1. Yogesh Preet Singh1,
  2. Debaditya Roy1,
  3. Bhargavi Jois2 and
  4. Mohit Shetti3
  1. 1Rheumatology, Manipal Hospital HAL Airport road, Bangalore, Karnataka, India
  2. 2Nuclear Medicine, Manipal Hospital HAL Airport road, Bangalore, Karnataka, India
  3. 3Gastroenterology, Manipal Hospital HAL Airport road, Bangalore, Karnataka, India
  1. Correspondence to Dr Yogesh Preet Singh; yogeshmann{at}gmail.com

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.

  • Musculoskeletal and joint disorders
  • Drugs and medicines
  • Unwanted effects / adverse reactions
  • Rheumatology
  • Urological cancer

https://doi.org/10.1136/bcr-2022-249208

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    Footnotes

    • Twitter @debaditya_roy

    • Contributors DR, YPS, BJ and MS have made significant contributions to design, literature review, manuscript writing and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.