BCG and Autoimmunity: Another Two-Edged Sword

Complications rhumatologiques de la BCG-thérapie

“…L'efficacité du traitement antituberculeux est difficilement évaluable dans quatre observations en raison de l'association d'AINS ou de corticoïdes aux antituberculeux. Dans un cas [49], un traitement par corticoïdes (prednisolone 30 mg/jour) a été efficace après un échec de deux semaines d'AINS. Il apparaît donc légitime dans l'état actuel de nos connaissances de débuter le traitement des polyarthrites induites par la BCG-thérapie par les AINS et de ne réserver le traitement par isoniazide et rifampicine qu'en cas d'échec de ce traitement.…”

Thrombocytopenia After Bacille Calmette-Guérin Immunization—possibly on an Immune Basis

“…BCG is known to stimulate the immune system to trigger autoimune diseases [7,8]. Systemic immune responses and autoimmune manifestations have been documented after intravesical instillation of BCG [8]. Nonetheless, there is no literature available talking about BCG vaccine triggering an immune thrombocytopenic purpura, especially in young infants.…”

“…The loss of antiplatelet antibodies and bone marrow megakaryocyte regeneration after a corticosteroid therapy suggested an immune-mediated disease. BCG is known to stimulate the immune system to trigger autoimune diseases [7,8]. Systemic immune responses and autoimmune manifestations have been documented after intravesical instillation of BCG [8].…”

“…So the possibility of cross-antigenicity between mycobacterial antigens and host (human) antigens has been examined [11]. The results indicated that infecting mycobacteria share some antigens with human tissue, which accounts for some production of autoantibodies during a mycobacterial infection [8].…”

Tuberculosis as a Trigger of Retroperitoneal Fibrosis

“…been linked to autoimmunity [9][10][11]. Mouse monoclonal anti-M. tuberculosis antibodies can recognize autoantigens such as thyroglobulin, myosin, and collagen [12] and, in autoimmunity-prone mice, a single dose of bacille Calmette-Guérin has induced a systemic, lupuslike syndrome [13].…”