Granulomatous Hepatitis Following Intra-Vesical Instillation of Bacillus Calmette–Guérin for Treatment of Bladder Cancer

Intra-vesical instillation of bacillus Calmette–Guérin (BCG) is an important treatment modality of superficial bladder cancer. It is usually well tolerated, although some adverse reactions can occur. One possible yet rare complication is granulomatous hepatitis, that is thought to be caused either b...

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Bibliographic Details
Published inInfectious disease reports Vol. 13; no. 3; pp. 611 - 618
Main Authors Branco, Elsa Alves, Duro, Raquel, Brito, Teresa, Sarmento, António
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 01.07.2021
MDPI
Subjects
Acids
Anorexia
bacillus Calmette–Guérin
Biopsy
Bladder
Bladder cancer
Cancer
Case Report
Enzymes
Fever
Gallbladder diseases
Granulomas
Granulomatous hepatitis
Hepatitis
Hepatitis A
Histology
Hypersensitivity
Immunotherapy
Infections
Liver
Tuberculosis
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Summary:Intra-vesical instillation of bacillus Calmette–Guérin (BCG) is an important treatment modality of superficial bladder cancer. It is usually well tolerated, although some adverse reactions can occur. One possible yet rare complication is granulomatous hepatitis, that is thought to be caused either by BCG infection or a hypersensitivity reaction to the bacillus. We present a case of a 79-year-old apparently immunocompetent patient who developed granulomatous hepatitis a few months after BCG administration for bladder cancer immunotherapy. It is important to notice that acid-fast smears and cultures are often negative, and these should not exclude diagnosis nor delay treatment. Our case highlights the importance of clinical suspicion and prompt initiation of appropriate treatment.
ISSN:2036-7449
2036-7430
2036-7449
DOI:10.3390/idr13030057