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KMID : 0388219950020020192
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Journal of the Korean Rheumatism Association
1995 Volume.2 No. 2 p.192 ~ p.196
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A Case Arthritis after Intravesical BCG Instillation for Bladder Cancer
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임미경
이성순/박효숙/김찬/장윤혜/최승원/유빈/문희범
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Abstract
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Intravesical instillation of BCG(Calmette-Guerin Bacillus) is the most widely used treatment of superficial transitional cell carcinoma of the bladder. While the exact mechanisms are not yet known, it is assumed that the recognition of tumor
antigen is
enhanced by immunologic response of the urothilium of mycobacteioum. Various complications have been reported after BCG treatment and arthritis is observed in 0.5 to% of treated patients. This from of arthritis may be attributed to an antigen of
mycobacterium sharing a cross reactive epitope with an antibgen in articular cartilage.
A 40-year-old male had transurethral resection and intravesical instillation of BCG for transitional cell carcinoma of bladder. Within fedw day of the fourth instillation, he developed arthritis on right knee and right metatarsal joint.
Laboratory
findings showed nonspectific inflammatory sign, positive HLA B27, negative rheumatoid fcor and negative antinuclear antibody. The joint effusion was asepjtic. He was treated with nonsteroidal antiinflammatory drugs (indomethacin 200mg/day) with
resolution of arthritis symptom. We report a patient who developed an inflammatory oligoarthritis following intravesical instillation of BCG for the treatment oof bladder cancer.
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KEYWORD
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