Table 1.
Clinical spectrum of renal presentations, treatment and their outcome following Intravesical BCG
| Year/ Ref | Age | Sex | Clinical Presentation | Initial SCr(mg/dL) | BCG Strain | BCG Instillations | Renal Histology | Granuloma | Treatment | Recovery | Last SCr(mg/dL) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1991 [21] | 70 | M | VH, Raised Cr | 3 | Pasteur | 11 | Interstitial epitheloid granulomas | Yes | I + P | Partial | 1.8 |
| 1991 [21] | 70 | M | ARF | 5.4 | Pasteur | 18 | Interstitial nephritis with mesangial IgM and C3 deposits | No | I + E + P | Poor Died |
Off HD; CrCl 10 |
| 1991 [21] | 48 | M | Hematuria and Proteinuria | 1.3 | Pasteur | 9 | Diffuse mesangial proliferation with subendothetial deposits of IgG + C3 and moderate interstitial fibrosis; | No | I + R | Complete | |
| 2000 [8] | 72 | M | ARF- HUS, Rhabdomyolysis | 3.8 | ? | 8 | No biopsy as patient too unwell | N/A | Pl.Ex, HD | None Died |
– |
| 2000 [25] | 67 | M | UTI | ? | Renal caseating granulomas | Yes | I + R + Pip | Complete | – | ||
| 2001 [14] | 57 | F | UTI | – | Tokyo | 5 | – | NA | Pulse CS | Complete | – |
| 2001 [14] | 76 | M | UTI | – | Tokyo | 6 | – | NA | Pulse CS | Complete | – |
| 2005 [22] | 72 | M | ARF | 2.9 | Tice | 9 | Acute tubulointersttial nephritis. Mesangial proliferation + focal segmental changes;IF-ve | No | I + R + P | Partial | 1.9 |
| 2006 [23] | 72 | F | ARF | 3.1 | Connaught | 5 | Diffuse Interstitial Nephritis +2 non-necrotising Granulomas; IF nonspecific IgM + C3 | Yes | Pred alone | Complete | 1.3 |
| 2007 [24] | 76 | M | ARF | 6.5 | ? | 10 | Diffuse and severe interstitial nephritis | No | MP, Pred | Partial | 3.4 |
| 2007 [18] | 54 | M | Nephrotic Syndrome | Normal | ? | 12 | Membranous glomerulonephritis - IgM, C3 and IgG+ | No | Pred alone | Complete Remission |
Normal |
| 2013 [12] | 76 | M | AKI | 7.9 | ? | 10 | Tubulointerstitial nephritis with moderate eosinophilic infiltrate | No | Oral MP, ATT, HD | Partial | Off HD; 2.5 |
| 2015 [15] | 52 | M | Surveillance CT | 1.2 | Onco Tice | 18 | Necrotising granuloma with no interstitial inflammation; IF not done; | Yes | ATT | Complete | 1.2 |
| 2015 [16] | 68 | M | VH | – | OncoTice | 18 | Non-necrotising granulomas | Yes | None | Complete | – |
| 2015 [16] | 74 | M | NVH | – | OncoTice | 9 | Chronic Granulomatous Interstitial Nephritis | Yes | None | Complete | – |
| 2017 [17] | 80 | M | AKI-RPGN HSP |
3.6 | Connaught | 8 | IgA-Fibrinoid necrosis + 20% crescents Mesangial IgA. Skin- HSP vasculitis | No | MP, Pred Pl.Ex, HD |
Partial Died |
Off HD; 2.8 |
| Present | 73 | F | Advanced CKD5 | 4 | OncoTice | 16 | Interstitial nephritis with granuloma and acute/chronic tubular damage, IF negative | Yes | Pred alone | Poor | 3.3 |
AAT Antituberculous Therapy, AKI Acute Kidney injury, ARF Acute renal failure, CS Corticosteroids, E Ethambutol, HD Hemodialysis, HSP Henoch ≈Schönlein Purpura, HUS Haemolytic Uremic Syndrome, IgA Immunoglobulin A, I Isoniazid, MP Methyl Prednisolone, NVH Non-Visible Haematuria, Pip Piperacillin, Pl.Ex Plasma Exchange, Pred Prednisolone, P Pyrazinamide, R Rifampicin, SCr Serum creatinine, VH Visible Haematuria, RPGN Rapidly Progressive Glomerulonephritis, UTI Urinary Tract Infection