GRANULOMATOUS HEPATITIS AS A COMPLICATION OF INTRAVESICAL BACILLUS-CALMETTE-GUERIN THERAPY FOR BLADDER-CARCINOMA

Bacillus Calmette-Guerin (BCG) therapy has been proven to be effective treatment for superficial bladder carcinoma with complications that a re usually minor and self limited. Although rare, granulomatous hepati tis can develop, and it is important to recognize it and treat it prom ptly. The hepatitis which occurs appears to be the result of a hyperse nsitivity reaction to antigens present in the BCG vaccine. Pathologica l findings include hepatocellular necrosis and pleomorphism, microgran ulomas and noncaseous epitheliod granulomas with giant cells. A case o f BCG-hepatitis, which developed in a 74-year-old white male following immunotherapy for superficial bladder carcinoma, is described.