[膀胱内卡介苗治疗第二疗程期间发生反应性关节炎需使用甲氨蝶呤治疗：一例报告]

[Reactive Arthritis during the Second Course of Intravesical BCG Therapy Requiring Administration of Methotrexate : A Case Report].

作者信息

Ikeuchi Ryosuke, Sunada Takuro, Yoshikawa Takeshi, Yoshida Toru, Tabuchi Yuya, Kajita Yoichiro, Segawa Takehiko

机构信息

The Department of Urology, Kyoto City Hospital.

The Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University; The Department of general medicine, Kyoto City Hospital.

出版信息

Hinyokika Kiyo. 2017 Aug;63(8):329-332. doi: 10.14989/ActaUrolJap_63_8_329.

DOI:10.14989/ActaUrolJap_63_8_329

PMID:28889718

Abstract

Reactive arthritis, formerly called Reiter's syndrome, is one of the rare complications following intravesical instillation of Bacillus Calmette Guerin (BCG). A 58-year-old man was admitted to our hospital because of fever, hyperemia of conjunctiva, and arthralgia following the second course of intravesical instillation of BCG in the treatment of pT1 and pTis bladder cancer. We diagnosed him with reactive arthritis due to the clinical course. Reactive arthritis is usually well controlled with the discontinuation of instillation and administration of nonsteroidal anti-inflammatory drugs (NSAIDs). However, his symptoms were not improved after administration of NSAIDs, prednisolone, and isoniazid. Following initiation of methotrexate, however, there was remission. He has been free from recurrence of bladder cancer for 20 months.

摘要

反应性关节炎，以前称为赖特综合征，是膀胱内灌注卡介苗（BCG）后罕见的并发症之一。一名58岁男性因在治疗pT1和pTis膀胱癌的第二个疗程膀胱内灌注BCG后出现发热、结膜充血和关节痛而入住我院。根据临床病程，我们诊断他患有反应性关节炎。反应性关节炎通常通过停止灌注和使用非甾体抗炎药（NSAIDs）得到很好的控制。然而，在使用NSAIDs、泼尼松龙和异烟肼后，他的症状并未改善。然而，在开始使用甲氨蝶呤后，病情缓解。他的膀胱癌已经20个月没有复发了。