Hemophagocytic lymphohistiocytosis and pulmonary embolism caused by bacillus Calmette-Guerin intravesical instillation

Hemophagocytic lymphohistiocytosis and pulmonary embolism caused by bacillus Calmette-Guerin intravesical instillation

Authors

  • Antonio Fabozzi Sapienza University of Rome https://orcid.org/0009-0006-6070-428X
  • Gianluca Paciucci Department of Public Health and Infectious Diseases, Division of Pneumology, “Sapienza” University of Rome, Italy
  • Emma Repaci Department of Public Health and Infectious Diseases, Division of Pneumology, “Sapienza” University of Rome, Italy
  • Alessandra Iacovelli Department of Public Health and Infectious Diseases, Division of Pneumology, “Sapienza” University of Rome, Italy https://orcid.org/0000-0002-7103-7842
  • Luigi Panza Department of Public Health and Infectious Diseases, Division of Pneumology, “Sapienza” University of Rome, Italy
  • Ambra Migliarini Department of Public Health and Infectious Diseases, Division of Pneumology, “Sapienza” University of Rome, Italy
  • Cristina Santoro Department of Translational and Precision Medicine, Division of Hematology, “Sapienza” University of Rome, Italy
  • Paolo Palange Department of Public Health and Infectious Diseases, Division of Pneumology, “Sapienza” University of Rome

Keywords:

Pulmonary Embolism, Hemophagocytic Lymphohistiocytosis, Bacillus Calmette-Guerin, Bladder Carcinoma, Respiratory Failure, Cytopenia

Abstract

Current international guidelines for bladder carcinoma recommend the use of intravesical instillations of chemotherapeutic agents, including bacillus Calmette-Guérin, for the prevention of recurrences in high-grade non-muscle-invasive bladder carcinomas. Treatment with Bacillus Calmette-Guérin is generally well-tolerated. Usually, adverse effects are mild and reversible with discontinuation of therapy. Severe adverse reactions are rare and may include hemophagocytic lymphohistiocytosis, even only few cases have been described none associated with pulmonary embolism.  In this report, we describe the case of a 66-year-old patient who develops low-grade (LG) pulmonary embolism and hemophagocytic lymphohistiocytosis after the third session of intravesical instillation. He was treated with high doses of corticosteroid therapy with a restitutio ad integrum of the clinical and laboratory parameters. 

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Published

28-08-2024

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Section

CASE REPORTS

How to Cite

1.
Fabozzi A, Paciucci G, Repaci E, Iacovelli A, Panza L, Migliarini A, et al. Hemophagocytic lymphohistiocytosis and pulmonary embolism caused by bacillus Calmette-Guerin intravesical instillation. Acta Biomed [Internet]. 2024 Aug. 28 [cited 2024 Oct. 5];95(4):e2024104. Available from: https://mail.mattioli1885journals.com/index.php/actabiomedica/article/view/15527