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Austin J Surg. 2019; 6(9): 1183.
Tuberculous Aortic Aneurysm and Interstitial Nephritis after BCG Therapy
Etienne L, Philippe R, Mihalea B, Elodie C, Hélène C, Lorraine L, Claire R, Julien S*
Infectious diésasse Unit, Valence Hospital, France
*Corresponding author: SAISON Julien, Infectious disease unit, Valence Hospital, 179 boulevard du Marechal Juin, 26 000 Valence, France
Received: April 17, 2019; Accepted: April 25, 2019; Published: May 02, 2019
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A 63-year-old male patient presented with fever, back pain, acute renal failure (13ml/min/1.73m2), and six months after starting a BCG therapy for bladder carcinoma. The renal biopsy found interstitial gigantocellular epithelioid and necrotizing granulomas (panel A, blue circle). The PET-scan revealed an aortic mycotic aneurysm involving the renal arteries (panel B, white arrow). An antituberculous treatment for seven month was started, with a tapering systemic corticotherapy for 3 months. As the aneurysm increased with a reactionnal L2 vertebral osteolysis, a two-step surgery was performed (laparoscopic bi renal revascularization, followed by an aortic endoprosthesis). One year after stopping antituberculous treatment, bladder carcinoma was in remission, the renal clearance was stable at 30 ml/min/1.73m2, and the patients remained with an asymptomatic vertebral ostolysis and a fonctionnal endoprothesis (Panel C, blacks arrows). Association of an interstitial nephritis and an aortic aneurysm is a rare life threatening medico-surgical complication of BCG therapy.
Figure 1:
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