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has been cited by the following article:

• TITLE: Late and Reversible Kidney-Lung Failure after Intra-Bladder BCG Therapy

  AUTHORS: Olivier Mat, Rim Kada, Patrick Philippart, Quentin Mat, Steffy Larroze, Myriam Remmelink, Selda Aydin, Vincent Colombie

  KEYWORDS: Corticosteroids; Hemodialysis; Intravesical BCG; Mycobacterium bovis; Pulmonary Granulomatosis; Renal Failure; Tubulointerstitial Nephritis; Urothelial Carcinoma

  JOURNAL NAME: Open Journal of Nephrology, Vol.3 No.3, September 9, 2013

  ABSTRACT: We observed a 76-year-old man who presented “acute kidney-lung failure” 9 months after intravesical Bacillus Calmette-Guérin (BCG) adjuvant treatment for a T1 bladder cancer. He had inflammatory infiltration on chest radiography and required dialysis for acute renal failure. A percutaneous renal biopsy was performed and revealed tubulointerstitial nephritis with a moderate eosinophilic infiltrate without granulomatous lesion. After a few days, an open lung biopsy was also done due to respiratory deterioration. The anatomopathologic specimen demonstrated moderate fibrosis with lympho-neutrophilic infiltration and few aspecific granulomatous lesions without caseous necrosis. Sarcoidosis was suspected and high dose oral methylprednisolone was started. Three weeks later, Mycobacterium bovis was identified by Polymerase Chain Reaction on open lung biopsy. He responded well to steroids and tuberculostatic tri-therapy. After one month of immunosuppressive treatment, renal function was resolved and hemodialysis could be discontinued. Despite the frequent use of adjuvant BCG immunotherapy, systemic complications such as hepatitis, pneumonitis, spondylodiscitis or multiorgan failure are rare (