Year 2025 / Volume 117 / Number 12
Letter
Abdominal BCGitis with hepatosplenic and lymphatic involvement following intravesical therapy: a rare complication

797-799

DOI: 10.17235/reed.2025.11384/2025

Pablo Fernández Rodríguez, Lidia Castillo Gázquez, Susana Tomás Álvarez, Fernando Casals Seoane, María Caldas Álvarez, Rosario Serrano Pardo, Cecilio Santander Vaquero, Elena Resina Sierra,

Abstract
Disseminated Bacillus Calmette-Guérin (BCG) disease, known as BCGitis, is a rare but potentially severe systemic complication of intravesical BCG therapy, which is used in the treatment of non-muscle invasive bladder cancer (NMIBC). Hepatic involvement in the form of granulomatosis typically presents as an early complication (within days to weeks after therapy), manifesting with clinical and laboratory findings such as abdominal pain, fever, and a cholestatic pattern. Definitive diagnosis is established through microbiological isolation of BCG and the identification of epithelioid granulomas in target organs, which enables the initiation of specific antituberculous treatment. The diagnostic process is often challenging due to the difficulty of microbiological confirmation and the variable timing of associated complications, necessitating a multidisciplinary approach involving gastroenterologists, pathologists, and other specialists.
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References
1. Mironova M, Gopalakrishna H, Rodriguez Franco G, Holland SM, Koh C, Kleiner DE, Heller T. Granulomatous liver diseases. Hepatol Commun. 2024 Mar 18;8(4):e0392.
2. Liu Y, Lu J, Huang Y, Ma L. Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer. J Oncol. 2019 Mar 10;2019:6230409.
3. Cabas P, Rizzo M, Giuffrè M, Antonello RM, Trombetta C, Luzzati R, Liguori G, Di Bella S. BCG infection (BCGitis) following intravesical instillation for bladder cancer and time interval between treatment and presentation: A systematic review. Urol Oncol. 2021 Feb;39(2):85-92.
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Fernández Rodríguez P, Castillo Gázquez L, Tomás Álvarez S, Casals Seoane F, Caldas Álvarez M, Serrano Pardo R, et all. Abdominal BCGitis with hepatosplenic and lymphatic involvement following intravesical therapy: a rare complication. 11384/2025


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Publication history

Received: 02/06/2025

Accepted: 13/06/2025

Online First: 27/06/2025

Published: 12/12/2025

Article Online First time: 25 days

Article editing time: 193 days


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