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Polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema following intravesical instillation of bacillus Calmette-Guerin
Intravesical instillation of bacillus Calmette-Guerin (BCG) after transurethral cancer resection is an approved part of the management of non-muscle invasive bladder cancer (NMIBC). The onset of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE)...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753592/ https://www.ncbi.nlm.nih.gov/pubmed/31548753 http://dx.doi.org/10.5114/reum.2019.87617 |
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author | Manzo, Ciro |
author_facet | Manzo, Ciro |
author_sort | Manzo, Ciro |
collection | PubMed |
description | Intravesical instillation of bacillus Calmette-Guerin (BCG) after transurethral cancer resection is an approved part of the management of non-muscle invasive bladder cancer (NMIBC). The onset of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) following this immunotherapy is anecdotal. We report the case of a 69-year-old male patient suffering from boxing-glove swelling of the hand associated with bilateral pain, aching and stiffness in the shoulders and pelvic girdles, which occurred after a cycle of six intravesical instillations of BCG. Polymyalgia rheumatica associated with RS3PE was diagnosed, prednisone therapy started and definitively stopped after 13 months. During a 16-year follow-up, no alternative diagnosis was possible. The role of genetic factors and of the senescence of the immune system is discussed. According to our best knowledge, this is the first case report of PMR associated with RS3PE following intravesical instillation of BCG. |
format | Online Article Text |
id | pubmed-6753592 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie |
record_format | MEDLINE/PubMed |
spelling | pubmed-67535922019-09-23 Polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema following intravesical instillation of bacillus Calmette-Guerin Manzo, Ciro Reumatologia Case Report Intravesical instillation of bacillus Calmette-Guerin (BCG) after transurethral cancer resection is an approved part of the management of non-muscle invasive bladder cancer (NMIBC). The onset of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) following this immunotherapy is anecdotal. We report the case of a 69-year-old male patient suffering from boxing-glove swelling of the hand associated with bilateral pain, aching and stiffness in the shoulders and pelvic girdles, which occurred after a cycle of six intravesical instillations of BCG. Polymyalgia rheumatica associated with RS3PE was diagnosed, prednisone therapy started and definitively stopped after 13 months. During a 16-year follow-up, no alternative diagnosis was possible. The role of genetic factors and of the senescence of the immune system is discussed. According to our best knowledge, this is the first case report of PMR associated with RS3PE following intravesical instillation of BCG. Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie 2019-08-31 2019 /pmc/articles/PMC6753592/ /pubmed/31548753 http://dx.doi.org/10.5114/reum.2019.87617 Text en Copyright: © 2019 Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Case Report Manzo, Ciro Polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema following intravesical instillation of bacillus Calmette-Guerin |
title | Polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema following intravesical instillation of bacillus Calmette-Guerin |
title_full | Polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema following intravesical instillation of bacillus Calmette-Guerin |
title_fullStr | Polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema following intravesical instillation of bacillus Calmette-Guerin |
title_full_unstemmed | Polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema following intravesical instillation of bacillus Calmette-Guerin |
title_short | Polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema following intravesical instillation of bacillus Calmette-Guerin |
title_sort | polymyalgia rheumatica and remitting seronegative symmetrical synovitis with pitting edema following intravesical instillation of bacillus calmette-guerin |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753592/ https://www.ncbi.nlm.nih.gov/pubmed/31548753 http://dx.doi.org/10.5114/reum.2019.87617 |
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