BCG-induced pneumonitis with lymphocytic pleurisy in the absence of elevated KL-6

BMC Pulmonary Medicine

Fumitaka Ogushi⁵  Nobuo Hatakeyama⁵  Keishi Naruse¹  Shinji Mukai³  Takahira Kuno⁴  Tsutomu Shinohara²  Makoto Tobiume⁵ 

[1] Division of Pathology, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi 780-8077, Japan;Department of Clinical Investigation, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi 780-8077, Japan;Division of Clinical Laboratory, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi 780-8077, Japan;Division of Urology, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi 780-8077, Japan;Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi 780-8077, Japan

关键词: Bronchoalveolar lavage;    Hypersensitivity pneumonitis;    BCG immunotherapy;   

Others  :  866505
DOI  :  10.1186/1471-2466-14-35

 received in 2013-02-20, accepted in 2014-02-27,  发布年份 2014

【 摘 要 】

Background

Pneumonitis is a rare complication of bacillus Calmette-Guerin (BCG) immunotherapy seen in patients with urothelial cancer following the repeated administration of BCG. However, no case of BCG-induced pleurisy has been reported.

Case presentation

We here report the first case of pneumonitis with lymphocytic pleurisy following bacillus Calmette-Guerin (BCG) immunotherapy. Although marked T helper cell alveolitis was found by bronchoalveolar lavage and transbronchial biopsies, no acid-fast bacillus could be identified in recovered BALF or pleural effusion. The lymphocyte stimulation test of BCG was strongly positive. However, levels of serum and bronchoalveolar lavage fluid KL-6, a useful marker for hypersensitivity pneumonitis (HP), were within normal ranges.

Conclusion

We speculate that the pathogenesis of our case may be a hypersensitive reaction to the proteic component of BCG entering the lung and pleural space, which is different from the etiology of the common type of HP.

【 授权许可】

   
2014 Tobiume et al.; licensee BioMed Central Ltd.

【 图 表 】

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