A case of thoracic infectious aortic aneurysm with severe thrombocytopenia after BCG intravesical instillation therapy

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  • Takebe Mariko
    Department of Anesthesiology, Faculty of Medicine, Academic Assembly, University of Toyama Operation Department of Toyama University Hospital
  • Kubota Ryohei
    Department of Anesthesiology, Faculty of Medicine, Academic Assembly, University of Toyama
  • Hibi Daisuke
    Department of Anesthesiology, Faculty of Medicine, Academic Assembly, University of Toyama
  • Honda Yasuko
    Department of Anesthesiology, Faculty of Medicine, Academic Assembly, University of Toyama
  • Shakunaga Kiyoshi
    Department of Anesthesiology, Faculty of Medicine, Academic Assembly, University of Toyama Operation Department of Toyama University Hospital

Bibliographic Information

Other Title
  • 高度な血小板減少を合併した膀胱内BCG注入療法後感染性胸部大動脈瘤の1例
  • コウド ナ ケッショウバン ゲンショウ オ ガッペイ シタ ボウコウ ナイ BCG チュウニュウ リョウホウ ゴ カンセンセイ キョウブ ダイドウミャクリュウ ノ 1レイ

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Abstract

<p>　We report the case of a patient who presented with a thoracic infectious aortic aneurysm after Bacillus Calmette-Guérin (BCG) intravesical instillation therapy with concomitant severe thrombocytopenia. A-64-year-old man was transferred to our hospital for the treatment of a thoracic aortic aneurysm impending rupture. He was diagnosed with an infectious aortic aneurysm and was treated previously in another hospital. We performed thoracic endovascular aortic repair on the day of admission. The first laboratory examination at our hospital showed low blood platelet count, and thrombocytopenia persisted even after surgery.</p><p>　We diagnosed immune thrombocytopenia (ITP) because bone marrow examination showed increased giant cell count. Immunoglobulin therapy, Helicobacter pylori removal therapy, and thrombopoiesis-stimulating protein therapy were administered, and the platelet count increased post treatment. He was discharged on postoperative day 84. Five months later, mycobacteria were detected in his bloody sputum specimen, and further investigation revealed a tuberculous aortic aneurysm caused by BCG intravesical instillation therapy.</p>

Journal

  • Cardiovascular Anesthesia

    Cardiovascular Anesthesia 26 (1), 15-20, 2022-09-01

    Japanese Society of Cardiovascular Anesthesiologists

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