{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T02:46:19Z","timestamp":1783737979077,"version":"3.55.0"},"reference-count":10,"publisher":"SMC Media","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Intravesical bacillus Calmette-Gu\u00e9rin (BCG) instillation is widely used for the treatment of superficial bladder cancer. BCGitis is a serious immune-mediated complication with systematic manifestations and a high mortality rate. Here, we describe a case of a 64-year-old male patient who presented with haemophagocytic lymphohistiocytosis syndrome (HLH) after BCG instillation and was effectively treated with high-dose dexamethasone, intravenous immunoglobulins and anti-tuberculosis treatment.<\/jats:p>","DOI":"10.12890\/2022_003395","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T04:47:00Z","timestamp":1666327620000},"source":"Crossref","is-referenced-by-count":6,"title":["Secondary Haemophagocytic Lymphohistiocytosis Syndrome (HLH) After Intravesical Instillation of Bacillus Calmette-Gu\u00e9rin (BCG): A Case Report and Review of the Literature"],"prefix":"10.12890","volume":"9","author":[{"given":"Konstantinos","family":"Manganas","sequence":"first","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelara","family":"Maria","sequence":"first","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Bountzona","sequence":"first","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Karamanakos","sequence":"first","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelos","family":"Toskas","sequence":"first","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10397","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"10.12890\/2022_003395_ref1","doi-asserted-by":"crossref","unstructured":"<li>Alhunaidi O, Zlotta AR. The use of intravesical BCG in urothelial carcinoma of the bladder. <em>Ecancermedicalscience<\/em>> 2019;<strong>13<\/strong>:905. <\/li>","DOI":"10.3332\/ecancer.2019.905"},{"key":"10.12890\/2022_003395_ref2","doi-asserted-by":"crossref","unstructured":"<li>Sharma V, Thakur APS, Ramasamy V, Shukla P.K, Solanki F.S, Choudhary A et al. Complications of intravesical BCG therapy in non-muscle invasive bladder cancer: our tertiary care centre experience. <em>Afr J Urol<\/em> 2020;<strong>26<\/strong>:90.<\/li>","DOI":"10.1186\/s12301-020-00099-6"},{"key":"10.12890\/2022_003395_ref3","doi-asserted-by":"crossref","unstructured":"<li>Morales A, Eidinger D, Bruce AW. Intracavitary bacillus Calmette-Guerin in the treatment of superficial bladder tumors. <em>J Urol<\/em> 1976;<strong>116<\/strong>:180\u2013182.<\/li>","DOI":"10.1016\/S0022-5347(17)58737-6"},{"key":"10.12890\/2022_003395_ref4","doi-asserted-by":"crossref","unstructured":"<li>Larsen ES, Nordholm AC, Lillebaek T, Holden IK, Johansen IS. The epidemiology of bacille Calmette-Gu\u00e9rin infections after bladder instillation from 2002 through 2017: a nationwide retrospective cohort study. <em>BJU Int<\/em>> 2019 Dec;<strong>124<\/strong>(6):910-916.<\/li>","DOI":"10.1111\/bju.14793"},{"key":"10.12890\/2022_003395_ref5","doi-asserted-by":"crossref","unstructured":"<li>Lamm DL, van der Meijden PM, Morales A, Brosman SA, Catalona WJ, Herr HW, et al. Incidence and treatment of complications of bacillus Calmette-Guerin intravesical therapy in superficial bladder cancer. <em>J Urol<\/em> 1992 Mar;<strong>147<\/strong>(3):596-600.<\/li>","DOI":"10.1016\/S0022-5347(17)37316-0"},{"key":"10.12890\/2022_003395_ref6","doi-asserted-by":"crossref","unstructured":"<li>P\u00e9rez-Jacoiste As\u00edn MA, Fern\u00e1ndez-Ruiz M, L\u00f3pez-Medrano F, Lumbreras C, Tejido \u00c1, San Juan R, et al. Bacillus Calmette-Gu\u00e9rin (BCG) infection following intravesical BCG administration as adjunctive therapy for bladder cancer: incidence, risk factors, and outcome in a single-institution series and review of the literature. <em>Medicine (Baltimore)<\/em> 2014 Oct;<strong>93<\/strong>(17):236-254.<\/li>","DOI":"10.1097\/MD.0000000000000119"},{"key":"10.12890\/2022_003395_ref7","doi-asserted-by":"crossref","unstructured":"<li>Padhi S, Ravichandran K, Sahoo J, Varghese RG, Basheer A Hemophagocytic lymphohistiocytosis: an unusual complication in disseminated Mycobacterium tuberculosis. <em>Lung India<\/em> 2015;<strong>32<\/strong>(6):593-601.<\/li>","DOI":"10.4103\/0970-2113.168100"},{"key":"10.12890\/2022_003395_ref8","doi-asserted-by":"crossref","unstructured":"<li>Misra S, Gupta A, Symes A, Duncan J. Haemophagocytic syndrome after intravesical bacille Calmette-Gu\u00e9rin instillation. <em>Scand J Urol<\/em> 2014 Jun;<strong>48<\/strong>(3):328-30. <\/li>","DOI":"10.3109\/21681805.2013.836724"},{"key":"10.12890\/2022_003395_ref9","doi-asserted-by":"crossref","unstructured":"<li>Schleinitz N, Bernit E, Harle JR. Severe hemophagocytic syndrome after intravesical BCG instillation. <em>Am J Med<\/em> 2002 May;<strong>112<\/strong>(7):593-4.<\/li>","DOI":"10.1016\/S0002-9343(02)01066-5"},{"key":"10.12890\/2022_003395_ref10","doi-asserted-by":"crossref","unstructured":"<li>Thevenot T, Di Martino V, Lagrange A, Petrella T, Faucher J-F, Fontan J, et al. Granulomatous hepatitis and hemophagocytic syndrome after bacillus Calmette-Guerin bladder instillation. <em>Gastroenterol Clin Biol<\/em> 2006 Mar;<strong>30<\/strong>(3):480-2.<\/li>","DOI":"10.1016\/S0399-8320(06)73208-0"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3395\/3266","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3395\/3267","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3395\/3267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T13:55:33Z","timestamp":1755784533000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/3395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,21]]},"references-count":10,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.12890\/2022_003395","relation":{"has-manifestation":[{"id-type":"other","id":"1-91-3395-g3266","asserted-by":"subject"},{"id-type":"other","id":"1-91-3395-g3267","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-91","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,21]]}}}