From Bladder to Joints: Reactive Arthritis Secondary to Intravesical-Bacillus Calmette-Guérin Immunotherapy

ABSTRACT

Reactive arthritis is a rare complication following Bacillus Calmette-Guérin (BCG) therapy for bladder cancer, often presenting with joint pain and systemic symptoms. A patient with high-risk non-muscle-invasive bladder cancer underwent Transurethral Resection of the Bladder Tumor (TURBT) followed by 4 doses of intravesical BCG therapy. Four weeks after treatment, the patient developed bilateral knee pain, swelling, difficulty walking, and fever, consistent with BCG-induced reactive arthritis. The patient’s symptoms improved with oral prednisolone, and BCG therapy was discontinued. A flare during steroid tapering was managed with methylprednisolone and sulfasalazine. At follow-up, C-Reactive Protein (CRP) levels normalized, indicating clinical improvement. BCG-induced reactive arthritis, though rare, should be considered in patients presenting with new-onset arthritis after BCG therapy. Early recognition and appropriate treatment are crucial for optimal management.

KEYWORDS

• Intravesical BCG Therapy
• Reactive Arthritis
• TURBT
• Bladder Tumor

Showing references and in-text citations exactly as published.

• DOI10.5530/ijopp.20260594Copy

RELATED ARTICLES

Matched on section and article type within this issue of IJPP.

• Article · VOLUME 19, ISSUE 3A Case Lichen Planus Pigmentosus an Uncommon Entity with Distinctive Characteristics: A Case ReportMuhammed Salah, Muhammed Shas, Nahdha K, Shariba Parveen, Anjali C S, Kameswaran R, Sirajudheen M K · pp. 389–391Case ReportSame type: Article
• Article · VOLUME 19, ISSUE 3A Challenging Case of High-Risk Pediatric AML with Novel ZNF348/SF11 Fusion and Mixed Phenotypic Features: Navigating Genomic Complexity, Resistant Infections, and MRD-Driven Therapy toward RemissionC. Dhandapani, Kavitha A · pp. 392–394Case ReportSame type: Article
• Article · VOLUME 19, ISSUE 3Fixed Drug Eruption Caused by EtoricoxibNiya Catherine · pp. 395–396Case ReportSame type: Article
• Article · VOLUME 19, ISSUE 3A Case of Dry Gangrene in an Autoimmune Patient: Diagnostic and Therapeutic ChallengesParshant Pokhriyal, Muskan Kumari, Damini Kharb, Subodh Gururani, Anuj Nautiyal · pp. 397–402Case ReportSame type: Article