BCG-related granulomatous hepatitis

Pneumologia. 2007 Jan-Mar;56(1):32-4.

Abstract

The development of granulomatous lesions in distant organs is an uncommon complication of the immunotherapy with BCG vaccine. We report a case of granulomatous hepatitis after the 12th BCG intravesical instillation (6 weekly followed by 6 monthly) in a 58-year-old man with superficial bladder cancer. The patient was admitted because of fever and jaundice. Disseminated BCG infection was suspected on the basis of history, clinical examination and a liver biopsy that showed noncaseating granulomatous hepatitis. PCR for M. bovis was positive in the liver tissue, confirming the mycobacterial dissemination. Our patient improved clinically with a regimen including both corticosteroids and antituberculosis agents.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravesical
  • Adrenal Cortex Hormones / therapeutic use
  • Animals
  • Antitubercular Agents / therapeutic use
  • BCG Vaccine / administration & dosage
  • BCG Vaccine / adverse effects*
  • Carcinoma, Transitional Cell / therapy
  • Cattle
  • Drug Therapy, Combination
  • Granuloma / microbiology*
  • Granuloma / pathology
  • Humans
  • Liver / microbiology
  • Liver / pathology
  • Male
  • Middle Aged
  • Mycobacterium Infections / complications*
  • Mycobacterium Infections / drug therapy
  • Mycobacterium bovis / isolation & purification*
  • Polymerase Chain Reaction
  • Treatment Outcome
  • Tuberculosis, Hepatic / drug therapy
  • Tuberculosis, Hepatic / microbiology*
  • Urinary Bladder Neoplasms / therapy

Substances

  • Adrenal Cortex Hormones
  • Antitubercular Agents
  • BCG Vaccine