-
Irish Medical Journal Aug 2022
Topics: Humans; Mycobacterium bovis; Tuberculosis; Absorption, Physiological
PubMed: 36301237
DOI: No ID Found -
Human Vaccines & Immunotherapeutics Aug 2020BCG has been recommended because of its efficacy against disseminated and meningeal tuberculosis. The BCG vaccine has other mechanisms of action besides tuberculosis... (Review)
Review
BCG has been recommended because of its efficacy against disseminated and meningeal tuberculosis. The BCG vaccine has other mechanisms of action besides tuberculosis protection, with immunomodulatory properties that are now being discovered. Reports have shown a significant protective effect against leprosy. Randomized controlled trials suggest that BCG vaccine has beneficial heterologous (nonspecific) effects on mortality in some developing countries. BCG immunotherapy is considered the gold standard adjuvant treatment for non-muscle-invasive bladder cancer. BCG vaccine has also been tested as treatment for diabetes and multiple sclerosis. Erythema of the BCG site is recognized as a clinical clue in Kawasaki disease. BCG administration in the immunodeficient patient is associated with local BCG disease (BCGitis) or disseminated BCG disease (BCGosis) with fatal consequences. BCG administration has been associated with the development of autoimmunity. We present a brief review of the diverse facets of the vaccine, with the discovery of its new modes of action providing new perspectives on this old, multifaceted and controversial vaccine.
Topics: Adjuvants, Immunologic; Autoimmunity; BCG Vaccine; Humans; Immunologic Deficiency Syndromes; Tuberculosis
PubMed: 31995448
DOI: 10.1080/21645515.2019.1706930 -
Urology Annals 2023Intravesical Calmette-Guérin (BCG) therapy for nonmuscle-invasive bladder cancer rarely leads to the development of granulomatous renal masses (renal BCGosis). The...
Intravesical Calmette-Guérin (BCG) therapy for nonmuscle-invasive bladder cancer rarely leads to the development of granulomatous renal masses (renal BCGosis). The management includes nephroureterectomy, antitubercular therapy (ATT), or both. Here, we present a case of a 62-year-old male who was treated with ATT alone for renal masses. Six months after intravesical BCG therapy for transitional cell carcinoma, he developed high-grade fever and night sweat and had multiple renal parenchymal hypodensities on computed tomography (CT) scan. Repeat CT scan 6 months after ATT revealed full resolution of renal hypodensities. This case report highlights the importance of follow-up for early detection of adverse effects of BCG treatment.
PubMed: 37304506
DOI: 10.4103/ua.ua_117_22 -
Journal of Surgical Case Reports Dec 2021Bacillus Calmette-Guerin (BCG) immunotherapy is a mainstay of adjunctive therapy for non-muscle-invasive bladder cancer. The instillation of BCG in the upper urinary...
Bacillus Calmette-Guerin (BCG) immunotherapy is a mainstay of adjunctive therapy for non-muscle-invasive bladder cancer. The instillation of BCG in the upper urinary tract after complete tumour eradication has also been studied and used after kidney-sparing management. It is effective in increasing the length of remission. However, it is also associated with rare but severe local and systemic side effects which may potentially become life-threatening. We present a case report of a 37-year-old gentleman who developed BCGosis following intra-renal instillation of BCG immunotherapy. The patient presented with systemic symptoms of jaundice, fever, myalgia and arthralgia, rather than local symptoms. infection was confirmed on blood cultures. The patient also developed hepatosplenomegaly, dyspnoea and pancytopaenia. BCGosis following intravesical instillation has been well documented in literature; to the best of our knowledge, this is the first case report documenting BCGosis following intra-renal instillation.
PubMed: 34934480
DOI: 10.1093/jscr/rjab544 -
Journal of Microbiology, Immunology,... Aug 2023
Review
Topics: Humans; Granulomatous Disease, Chronic; Hematopoietic Stem Cell Transplantation; Tuberculosis
PubMed: 36702645
DOI: 10.1016/j.jmii.2023.01.002 -
Indian Journal of Pediatrics Jul 2018
Topics: Humans; Infant; Severe Combined Immunodeficiency; Tuberculosis
PubMed: 29417456
DOI: 10.1007/s12098-018-2624-1 -
Journal of Genetics and Genomics = Yi... Apr 2020
Severe cases of BCGosis-susceptible primary immunodeficiency diseases identified by next-generation sequencing: Implications for adjustment of BCG vaccination timing in China.
Topics: BCG Vaccine; China; Female; High-Throughput Nucleotide Sequencing; Humans; Infant; Male; Mycobacterium tuberculosis; Primary Immunodeficiency Diseases; Tuberculosis; Vaccination
PubMed: 32482412
DOI: 10.1016/j.jgg.2020.03.003 -
Archives de Pediatrie : Organe Officiel... Jul 2016The Bacille Calmette-Guérin (BCG) vaccine is used extensively worldwide, and more than 100 million children are vaccinated each year. This is a live vaccine that...
The Bacille Calmette-Guérin (BCG) vaccine is used extensively worldwide, and more than 100 million children are vaccinated each year. This is a live vaccine that protects against severe tuberculosis in children. However, BCG complications, specific to the BCG vaccine, do occur, although the epidemiology differs from one country to another. Nevertheless, these complications are considered to be rare and range from benign local BCGitis to BCGosis, a potentially lethal disseminated disease. Etiologies of BCGitis/BCGosis can be related to the vaccine itself (technical errors, vaccinal strain) or to the patient. Indeed, it is well established that some immunodeficiencies, primary or acquired, can expose the patient to BCG disease. The diagnosis of a BCG disease lies on clinical examination and laboratory results. Recent advances in molecular biology help to distinguish BCG disease from other mycobacterial infections, especially from tuberculosis. When BCG complications have been confirmed, the underlying defect should be investigated, particularly if other features of immunodeficiency are reported, such as recurrent infection, failure to thrive, etc. Prognosis largely depends on the immune status, but also on the management of the BCG disease. Although the therapeutic protocols are still controversial, there are more and more publications on the diagnosis and management guidelines of the disease.
Topics: BCG Vaccine; Child; Humans; Inflammation; Osteomyelitis
PubMed: 27265585
DOI: 10.1016/j.arcped.2016.04.003 -
Pediatrics International : Official... Aug 2021Kawasaki disease (KD) is an acute systemic vasculitis that predominantly affects patients younger than 5 years. In the absence of an available, affordable diagnostic...
BACKGROUND
Kawasaki disease (KD) is an acute systemic vasculitis that predominantly affects patients younger than 5 years. In the absence of an available, affordable diagnostic test, detailed clinical history and physical examination are still fundamental to make a diagnosis.
METHODS
We present five representative cases with KD-like presentations: systemic onset juvenile idiopathic arthritis, mycoplasma-induced rash and mucositis, staphylococcal scalded skin syndrome, BCGosis, and the recently described multisystemic inflammatory syndrome in children (MIS-C) associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) virus.
RESULTS
Rash, fever, and laboratory markers of inflammation can be present in several childhood diseases that may mimic KD.
CONCLUSION
The term 'Kawasaki syndrome' instead of 'Kawasaki disease' may be more appropriate. Physicians should consider an alternative diagnosis that may mimic KD, particularly considering MIS-C during the present pandemic, as an aggressive diagnostic and therapeutic approach is needed.
Topics: COVID-19; Child; Humans; Mucocutaneous Lymph Node Syndrome; RNA, Viral; SARS-CoV-2; Systemic Inflammatory Response Syndrome
PubMed: 33249696
DOI: 10.1111/ped.14561 -
Clinical Nuclear Medicine Mar 2022BCGosis is a rare complication of intravesical BCG immunotherapy as adjuvant therapy for urinary bladder cancer manifesting in the form of disseminated tuberculosis or...
BCGosis is a rare complication of intravesical BCG immunotherapy as adjuvant therapy for urinary bladder cancer manifesting in the form of disseminated tuberculosis or organ-specific tuberculosis, rarely involving the vertebra. PSMA is overexpressed in prostate cancer but also expressed in a variety of benign and malignant conditions. We present a patient with incidental detection of abnormal uptake in a vertebral lesion during assessment of prostate cancer with 18F-PSMA PET/CT, subsequently proven to be vertebral osteitis, likely due to BCG immunotherapy. The case highlights the role of interdisciplinary patient assessment to confirm nature of abnormal foci on 18F-PSMA PET/CT.
Topics: Gallium Radioisotopes; Humans; Male; Niacinamide; Oligopeptides; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Spondylitis; Tuberculosis
PubMed: 35020662
DOI: 10.1097/RLU.0000000000003989