Title
Bacillus Calmette-Guérin-induced granulomatous hepatitis in a patient with a superficial bladder carcinoma Bacillus Calmette-Guérin-induced granulomatous hepatitis in a patient with a superficial bladder carcinoma
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Melville, N.Y. ,
Subject
Human medicine
Source (journal)
European journal of gastroenterology & hepatology. - Melville, N.Y.
Volume/pages
16(2004) :10 , p. 1027-1032
ISSN
0954-691X
ISI
000224650300012
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
A 71-year-old male patient with a superficial transitional cell carcinoma of the urinary bladder developed high fever and jaundice, accompanied by progressively increasing serum aminotransferase activities, 2 weeks after the fourth local instillation with an attenuated live strain of Mycobacterium bovis [bacillus Calmefte-Guerin (BCG)]. A liver biopsy showed non-caseating granulomatous hepatitis. Cultures for mycobacteria were negative. Mycobacterial DNA was not detected in liver tissue using the polymerase chain reaction. Empirical treatment with rifampicin and isoniazid was started, resulting in partial recovery. After 6 months of therapy, however, serum aminotransferase activities were still twice the upper limit of normal. A second liver biopsy still demonstrated several granulomas. Only after addition of prednisolone, liver tests completely normalized. Also histologically the lesions improved dramatically. This suggests that the BCG hepatitis was at least partially caused by a hypersensitivity reaction. Our patient is the first reported case of BCG hepatitis with histological follow-up under therapy.
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