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Table 1 Clinical spectrum of renal presentations, treatment and their outcome following Intravesical BCG

From: Emerging concepts and spectrum of renal injury following Intravesical BCG for non-muscle invasive bladder cancer

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

  1. 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