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Case of renal granulomatosis with polyangiitis following intravesical bacillus calmette-guérin therapy
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Case of renal granulomatosis with polyangiitis following intravesical bacillus calmette-guérin therapy
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Case of renal granulomatosis with polyangiitis following intravesical bacillus calmette-guérin therapy
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Journal Article
Case of renal granulomatosis with polyangiitis following intravesical bacillus calmette-guérin therapy
2018
Overview
Various adverse reactions may occur after intravesical bacillus Calmette-Guérin
(BCG) therapy. Although the virulence of attenuated BCG is low, serious complications such as
bacterial cystitis, bladder contractures, granulomatous prostatitis, epididymitis, orchitis, and
systemic reactions such as fever and malaise have been described. Disseminated granulomatosis
such as hepatitis and pneumonitis have also been described, but are rare. We report here the case
of a 67-year-old patient who presented with renal granulomatosis with polyangiitis following
intravesical BCG therapy for superficial bladder tumor. The biological evaluation revealed the
presence of perinuclear anti-neutrophil cytoplasmic antibodies with specificity for antimyeloperoxidase.
Renal biopsy specimen revealed pauci-immune crescentic glomerulonephritis
with segmental glomerular necrosis, presence of granulomas and no evidence of any caseating
necrosis. He received antituberculosis drugs in addition to corticosteroids and cyclophosphamide
without any improvement of the renal function
