Bilateral panuveitis following intravesical BCG immunotherapy for bladder carcinoma

Ocul Immunol Inflamm. 2010 Aug;18(4):292-6. doi: 10.3109/09273948.2010.486099.

Abstract

Purpose: To report a case of bilateral panuveitis following local treatment with Bacille Calmette-Guérin (BCG) immunotherapy for superficial bladder carcinoma.

Design: Case report and literature review.

Methods: A 70-year-old female presented with severe bilateral anterior chamber inflammation 5 days after intravesical BCG instillation. Despite topical steroids and mydriatics, inflammation worsened and bilateral optic nerve swelling developed.

Results: Oral corticosteroids settled the ocular inflammation, and optic nerve function recovered. A trial of steroid cessation caused rebound uveitis, so she remains on maintenance doses of oral corticosteroid.

Conclusions: Ocular inflammations following BCG therapy for bladder cancer are rare, and little is known about the management of such cases. This is the first report of bilateral panuveitis with optic nerve edema following such treatment.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravesical
  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • BCG Vaccine / adverse effects*
  • BCG Vaccine / therapeutic use
  • Carcinoma, Transitional Cell / drug therapy*
  • Dexamethasone / therapeutic use
  • Female
  • Humans
  • Immunotherapy / adverse effects*
  • Mydriatics / therapeutic use
  • Panuveitis / diagnosis*
  • Panuveitis / drug therapy
  • Panuveitis / immunology*
  • Prednisolone / therapeutic use
  • Urinary Bladder Neoplasms / drug therapy*
  • Visual Acuity / drug effects

Substances

  • Anti-Inflammatory Agents
  • BCG Vaccine
  • Mydriatics
  • Dexamethasone
  • Prednisolone