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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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Autor principal: Manzo, Ciro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie 2019
Materias:
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.
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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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