Haemophagocytic lymphohistiocytosis after intravesical BCG administration for bladder cancer presenting with multiorgan failure

G D Liatsos; G Manousopoulou; A Poulaki; A Iliaki; I Mariolis; D Vassilopoulos

doi:10.1099/acmi.0.000670.v3

Haemophagocytic lymphohistiocytosis after intravesical BCG administration for bladder cancer presenting with multiorgan failure

Access Microbiol. 2023 Sep 29;5(9):000670.v3. doi: 10.1099/acmi.0.000670.v3. eCollection 2023.

Authors

G D Liatsos¹, G Manousopoulou², A Poulaki², A Iliaki², I Mariolis², D Vassilopoulos²

Affiliations

¹ Department of Internal Medicine, "Hippokration" General Hospital, Athens, Greece.
² 2nd Department of Medicine and Laboratory, School of Medicine, National and Kapodistrian University of Athens, "Hippokration" General Hospital, Athens, Greece.

Abstract

Bacillus Calmette-Guérin (BCG), is administered intravesically as an adjuvant immunotherapy for the treatment of non-muscle invasive bladder cancer. While mild non-infectious problems can occur in up to 85 % of cases, significant local and systemic complications have been reported in 1-5 % of cases. We report the case of a patient with superficial bladder cancer who developed multiorgan failure after intravesical BCG instillation including the kidney and liver with subsequent haemophagocytic lymphohistiocytosis. Our case illustrates the first reported combination of secondary haemophagocytic lymphohistiocytosis with severe renal and liver failure after BCG immunotherapy for bladder carcinoma. Treatment strategy is discussed.

Keywords: BCG; haemophagocytosis; intravesical; kidney injury; liver failure.

Publication types

Case Reports