反应性关节炎——膀胱内卡介苗灌注的一种罕见并发症。
Reactive Arthritis - A Rare Complication of Intravesical BCG Instillation.
作者信息
Freixa Marta, Úria Sara, da Silva Glória Nunes
机构信息
Department of Internal Medicine, Hospital Pulido Valente, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.
出版信息
Eur J Case Rep Intern Med. 2020 Feb 4;7(3):001448. doi: 10.12890/2020_001448. eCollection 2020.
UNLABELLED
Reactive arthritis (ReA) with the classic triad of arthritis, conjunctivitis and urethritis, previously termed Reiter's syndrome, is a systemic illness, usually induced by genitourinary or gastrointestinal infections. However, it can be a rare complication of intravesical Bacillus Calmette-Guérin instillation (iBCG), a therapy prepared from attenuated strains of , a common and effective treatment for carcinoma in situ of the bladder (CisB). We report a case of a patient with CisB who developed ReA after iBCG. The symptoms resolved completely with corticosteroids. iBCG was stopped with no recurrence of carcinoma within 2 years.
LEARNING POINTS
ReA is an aseptic arthritis, usually triggered by genitourinary or gastrointestinal infections, generally in individuals positive for HLA-B27.Septic arthritis and microcrystalline arthritis can mimic ReA and they must be ruled out with arthrocentesis.ReA may be considered as a complication in patients under iBCG.
未标注
反应性关节炎（ReA）具有关节炎、结膜炎和尿道炎的经典三联征，以前称为赖特综合征，是一种全身性疾病，通常由泌尿生殖系统或胃肠道感染引起。然而，它可能是膀胱内卡介苗灌注（iBCG）的一种罕见并发症，iBCG是一种由卡介苗减毒株制备的疗法，是膀胱原位癌（CisB）的一种常用且有效的治疗方法。我们报告一例CisB患者在iBCG治疗后发生ReA的病例。症状通过皮质类固醇完全缓解。停用iBCG，2年内癌症未复发。
学习要点
ReA是一种无菌性关节炎，通常由泌尿生殖系统或胃肠道感染引发，一般发生在HLA - B27阳性个体中。化脓性关节炎和微晶性关节炎可模仿ReA，必须通过关节穿刺术排除。iBCG治疗的患者中，ReA可被视为一种并发症。
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