Bilateral Iritis after Vaccine for Bladder Cancer
Alberto Parafita-Fernández1, Manuel A Parafita
1*MD †MD, PhD Ophthalmology Department, Complejo Hospitalario de Pontevedra, Pontevedra, Spain (AP-F); and Clínica Oftalmológica Dr Parafita, Santa Eugenia de Ribeira, Spain (MAP).
Summary
Intravesical bacille Calmette-Guérin (BCG) immunotherapy for bladder cancer can cause uveitis. This case highlights a patient negative for HLA-B27 but positive for antinuclear antibody (ANA), suggesting broader diagnostic considerations.
Area of Science:
- Ophthalmology
- Urology
- Immunology
Background:
- Intravesical bacille Calmette-Guérin (BCG) is a standard immunotherapy for superficial bladder cancer.
- BCG instillation can lead to systemic side effects, including reactive arthritis and ocular inflammation like uveitis.
- Previous reports predominantly link BCG-induced uveitis to HLA-B27 positivity.
Observation:
- This case report details a patient who developed bilateral uveitis following BCG therapy for bladder cancer.
- The patient was negative for the typically associated HLA-B27 marker.
- Notably, the patient presented with low-positive antinuclear antibody (ANA) levels.
Findings:
- The occurrence of uveitis in an HLA-B27-negative patient treated with BCG is unusual.
- The presence of ANA positivity in this context warrants further investigation.
- This case challenges the established association of HLA-B27 with BCG-induced uveitis.
Implications:
- Increased physician awareness is crucial for early detection and management of BCG-associated uveitis.
- Ophthalmologists and urologists should consider uveitis in patients presenting with relevant symptoms post-BCG therapy.
- Further research is needed to understand the role of ANA in BCG-induced uveitis and its diagnostic utility.
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