Drug‐induced interstitial pneumonia after intravesical Bacillus Calmette‐Guerin administration for bladder cancer with scleroderma

Author:

Yoshioka Fumie1,Kato Taigo1ORCID,Shima Yoshihito23,Hatano Koji1,Kawashima Atsunari1ORCID,Fukuhara Shinichiro1ORCID,Imamura Ryoichi1,Nonomura Norio1

Affiliation:

1. Department of Urology Osaka University Graduate School of Medicine Osaka Japan

2. Department of Respiratory Medicine and Clinical Immunology Osaka University Graduate School of Medicine Osaka Japan

3. Department of Thermo‐Therapeutics for Vascular Dysfunction Osaka University Graduate School of Medicine Osaka Japan

Abstract

IntroductionIntravesical Bacillus Calmette‐Guerin administration is the standard therapy for high‐risk nonmuscle invasive bladder cancer and is usually well tolerated. However, some patients experience severe, potentially fatal, complications including interstitial pneumonitis.Case presentationA 72‐year‐old female with scleroderma was diagnosed with bladder carcinoma in situ. She developed severe interstitial pneumonitis with the first administration of intravesical Bacillus Calmette‐Guerin after the cessation of immunosuppressive agents. Six days after the first administration, she experienced dyspnea at rest, and computed tomography revealed scattered frosted shadows in the upper lung. The following day, she required intubation. We suspected drug‐induced interstitial pneumonia and started steroid pulse therapy for 3 days, resulting in a complete response. No exacerbation of scleroderma symptoms or recurrence of cancer was observed 9 months after Bacillus Calmette‐Guerin therapy.ConclusionFor patients receiving intravesical Bacillus Calmette‐Guerin therapy, close observation of the respiratory condition is necessary for early therapeutic intervention.

Publisher

Wiley

Subject

Urology

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