Reiter's syndrome following intravesical bacille bilié de Calmette-Guérin treatment for superficial bladder carcinoma: report of six cases

• Published in: Modern rheumatology Vol. 14; no. 1; pp. 82 - 86
• Main Authors: Murata, Hideyuki, Adachi, Yoshihiro, Ebitsuka, Takehiko, Chino, Yusuke, Takahashi, Reiko, Hayashi, Taichi, Goto, Daisuke, Matsumoto, Isao, Tsutsumi, Akito, Akaza, Hideyuki, Sumida, Takayuki
• Format: Journal Article
• Language: English
• Published: United States Informa Healthcare 01.03.2004
• ISSN: 1439-7595; 1439-7609
• DOI: 10.3109/s10165-003-0272-3

Abstract We report the cases of six patients who developed acute Reiter's syndrome following intravesical bacille bilié de Calmette-Guérin (BCG) immunotherapy for superficial bladder cancer. After the third to eighth BCG intravesical injection, the patients developed conjunctivitis, aseptic urethritis, and polyarthritis consistent with a diagnosis of Reiter's syndrome. HLA-B27 antigen was negative in five of the patients examined. Two of the patients responded to nonsteroidal anti-inflammatory drugs for polyarthritis, and the other four responded to steroids (prednisolone 5-10 mg/day). The frequent use of intracavitary BCG may increase the incidence of BCG-induced Reiter's syndrome. Further analysis of the relationship between HLA-B and -DR alleles and arthritis should shed light on the mechanism of BCG-induced Reiter's syndrome.