Division of Rheumatology, Department of Internal Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan,
Mod Rheumatol. 2004;14(1):82-6. doi: 10.1007/s10165-003-0272-3.
We report the cases of six patients who developed acute Reiter's syndrome following intravesical bacille biliE de Calmette-GuErin (BCG) immunotherapy for superficial bladder cancer. After the third to eighth BCG intravesical injection, the patients developed conjunctivitis, aseptic urethritis, and polyarthritis consistent with a diagnosis of Reiter's syndrome. HLA-B27 antigen was negative in five of the patients examined. Two of the patients responded to nonsteroidal anti-inflammatory drugs for polyarthritis, and the other four responded to steroids (prednisolone 5-10 mg/day). The frequent use of intracavitary BCG may increase the incidence of BCG-induced Reiter's syndrome. Further analysis of the relationship between HLA-B and -DR alleles and arthritis should shed light on the mechanism of BCG-induced Reiter's syndrome.
我们报告了 6 例患者的病例，他们在接受卡介苗（BCG）膀胱内免疫治疗浅表膀胱癌后出现急性瑞特综合征。在第三次至第八次 BCG 膀胱内注射后，患者出现了结膜炎、无菌性尿道炎和多关节炎，符合瑞特综合征的诊断。在检查的 5 名患者中，HLA-B27 抗原均为阴性。2 例多关节炎患者对非甾体抗炎药有反应，另外 4 例对激素（泼尼松龙 5-10mg/天）有反应。腔内 BCG 的频繁使用可能会增加 BCG 诱导的瑞特综合征的发病率。进一步分析 HLA-B 和-DR 等位基因与关节炎之间的关系，将有助于阐明 BCG 诱导的瑞特综合征的发病机制。
