T helper cell alveolitis after bacillus Calmette-Guerin immunotherapy for superficial bladder tumor.

We report a case of T helper cell alveolitis after intravesical bacillus Calmette-Guerin (BCG) immunotherapy for a superficial bladder tumor. Despite the clinical appearance of miliary pulmonary tuberculosis no mycobacterial agent was found. Therefore, we concluded that the patient had a hypersensitivity reaction similar to sarcoidosis. The condition improved after immunosuppressive therapy with glucocorticosteroids. Differentiation of bronchoalveolar cells could be useful in distinguishing hypersensitivity to infection with BCG.