Indian Journal of Pharmacy Practice logo
Submit
Indian Journal of Pharmacy PracticeACADEMIC PUBLISHING
Article

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

1, 2, 2

  1. 1Department of Rheumatology, Iqraa International Hospital and Research Centre, Calicut, Kerala, INDIA.
  2. 2Department of Clinical Pharmacy, Iqraa International Hospital and Research Center, Calicut, Kerala, INDIA.

CORRESPONDENCE

Shahsadhi Ittikapparambil Palakkal

Department of Clinical Pharmacy, Iqraa International Hospital and Research Center, Calicut, Kerala, INDIA.

ishahsadhi@gmail.com

Received: 07-11-2025; Accepted: 14-01-2026.

Volume 19, Issue 3 · pp. 407-410 · 2026 · DOI: 10.5530/ijopp.20260594

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

Open in new tab

REFERENCES

As published

Showing references and in-text citations exactly as published.

    Cite this article

    SELECT FORMAT

    Edavalath, S., Palakkal, S. I., & Achamveetil, S. (2026). From Bladder to Joints: Reactive Arthritis Secondary to Intravesical-Bacillus Calmette-Guérin Immunotherapy. Indian Journal of Pharmacy Practice, 19(3), 407-410. https://doi.org/10.5530/ijopp.20260594

    Copyright and licence

    © 2026 Author(s)

    This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. CC BY 4.0