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BCGitis

MedGen UID:
1684722
Concept ID:
C5139070
Disease or Syndrome
HPO: HP:0020086

Definition

Local or regional infection with Bacillus Calmette-Guerin (BCG) following vaccination. [from HPO]

Term Hierarchy

Conditions with this feature

Severe combined immunodeficiency due to DCLRE1C deficiency
MedGen UID:
355454
Concept ID:
C1865370
Disease or Syndrome
Severe combined immunodeficiency (SCID) due to DCLRE1C deficiency is a type of SCID (see this term) characterized by severe and recurrent infections, diarrhea, failure to thrive, and cell sensitivity to ionizing radiation.
Combined immunodeficiency due to ORAI1 deficiency
MedGen UID:
440578
Concept ID:
C2748568
Disease or Syndrome
Immunodeficiency-9 (IMD9) is an autosomal recessive disorder characterized by early onset of recurrent infections due to defective T-cell activation. Affected individuals also have congenital myopathy resulting in muscle weakness as well as features of ectodermal dysplasia, including soft dental enamel (summary by McCarl et al., 2009).
Mendelian susceptibility to mycobacterial diseases due to partial IRF8 deficiency
MedGen UID:
814919
Concept ID:
C3808589
Disease or Syndrome
Autosomal dominant IRF8 deficiency, or IMD32A, causes an abnormal peripheral blood myeloid phenotype with a marked loss of CD11C (ITGAX; 151510)-positive/CD1C (188340)-positive dendritic cells, resulting in selective susceptibility to mycobacterial infections (Hambleton et al., 2011).
Autosomal recessive primary immunodeficiency with defective spontaneous natural killer cell cytotoxicity
MedGen UID:
816672
Concept ID:
C3810342
Disease or Syndrome
Immunodeficiency-20 is a rare autosomal recessive primary immunodeficiency characterized by functional deficiency of NK cells. Patient NK cells are defective in spontaneous cell cytotoxicity, but retain antibody-dependent cellular cytotoxicity. Patients typically present early in childhood with severe herpes viral infections, particularly Epstein Barr virus (EBV), and human papillomavirus (HPV) (summary by Grier et al., 2012).
Mendelian susceptibility to mycobacterial diseases due to complete IL12B deficiency
MedGen UID:
862385
Concept ID:
C4013948
Disease or Syndrome
IMD29 results from autosomal recessive IL12B deficiency and is characterized by undetectable IL12B secretion from leukocytes. IL12B-deficient patients generally present with bacillus Calmette-Guerin (BCG) disease after vaccination in childhood, and at least half also have Salmonella infection. Infections with Mycobacterium tuberculosis and environmental mycobacteria have also been reported in IL12B-deficient patients. The phenotype is relatively mild, and patients have a good prognosis (review by Al-Muhsen and Casanova, 2008).
Mendelian susceptibility to mycobacterial diseases due to partial STAT1 deficiency
MedGen UID:
862387
Concept ID:
C4013950
Disease or Syndrome
Immunodeficiency-31A (IMD31A) results from autosomal dominant (AD) STAT1 deficiency. STAT1 is crucial for cellular responses to IFNA (147660)/IFNB (147640) (type I interferon) and IFNG (147570) (type III interferon). AD STAT1 deficiency selectively affects the IFNG pathway, but not the IFNA/IFNB pathway, and confers a predisposition to mycobacterial infections. Pathogens reported in IMD31A patients include bacillus Calmette-Guerin (BCG) and Mycobacterium avium complex, as well as Mycobacterium tuberculosis. IMD31A has low penetrance and a mild clinical phenotype with good prognosis for recovery (review by Al-Muhsen and Casanova, 2008). Two patients with heterozygous STAT1 mutations have been reported with increased susceptibility to adult-onset herpes simplex encephalitis (HSE) without a history of other significant infections (Mork et al., 2015).
Mendelian susceptibility to mycobacterial diseases due to complete ISG15 deficiency
MedGen UID:
863730
Concept ID:
C4015293
Disease or Syndrome
IMD38 predisposes individuals to severe clinical disease upon infection with weakly virulent mycobacteria, including Mycobacterium bovis Bacille Calmette-Guerin (BCG) vaccines (Bogunovic et al., 2012). Patients do not experience severe disease in response to viral infection. Affected individuals have intracranial calcification (Zhang et al., 2015).
Immunodeficiency 32B
MedGen UID:
865178
Concept ID:
C4016741
Disease or Syndrome
Immunodeficiency-32B is an autosomal recessive primary immunodeficiency characterized by recurrent infections resulting from variable defects in immune cell development or function, including monocytes, dendritic cells, and natural killer (NK) cells. Patients have particular susceptibility to viral disease (summary by Mace et al., 2017).
Immunodeficiency 69
MedGen UID:
1735911
Concept ID:
C5436498
Disease or Syndrome
Immunodeficiency-69 (IMD69) is an autosomal recessive disorder characterized by increased susceptibility to disseminated mycobacterial infection, including after BCG (bacille Calmette-Guerin) vaccination. Affected individuals develop fever, hepatosplenomegaly, leukocytosis, and thrombocytosis during the acute infection. There appears to be normal immunologic function against other pathogens, including viruses and bacteria. Immunologic work-up shows normal parameters, but patient T and NK cells fail to produce gamma-interferon (IFNG) when stimulated in vitro (summary by Kerner et al., 2020). IMD69 is a form of mendelian susceptibility to mycobacterial disease (MSMD) (see, e.g., IMD27A; 209950).
Immunodeficiency 86
MedGen UID:
1794205
Concept ID:
C5561995
Disease or Syndrome
Immunodeficiency-86 (IMD86) is an autosomal recessive immunologic disorder characterized by susceptibility to mycobacterial disease after exposure to BCG vaccine. Affected individuals usually develop localized mycobacterial lymphadenopathy that can be successfully treated without subsequent episodes (summary by Kong et al., 2018).
Autoinflammatory disease, multisystem, with immune dysregulation, X-linked
MedGen UID:
1840213
Concept ID:
C5829577
Disease or Syndrome
X-linked multisystem autoinflammatory disease with immune dysregulation (ADMIDX) is an X-linked recessive disorder with onset of symptoms in infancy or early childhood. Affected individuals may present with variable cytopenias, including anemia, thrombocytopenia, neutropenia, lymphopenia, or hypogammaglobulinemia, and systemic or organ-specific autoinflammatory manifestations. These include skin lesions, panniculitis, inflammatory bowel disease, pulmonary disease, or arthritis associated with recurrent fever, leukocytosis, lymphoproliferation, and hepatosplenomegaly in the absence of an infectious agent. Some patients have circulating autoantibodies that underlie the cytopenias or systemic features, whereas others do not have circulating autoantibodies. In addition, some patients have recurrent infections, whereas others do not show signs of an immunodeficiency. Laboratory studies are consistent with immune dysregulation, including altered B-cell subsets and variably elevated proinflammatory cytokines. Detailed functional studies of platelets, red cells, and T lymphocytes suggest that abnormal actin cytoskeleton remodeling is a basic defect, indicating that this disorder can be classified as an immune-related actinopathy. Severe complications of the disease may result in death in childhood (Boussard et al., 2023; Block et al., 2023).
Immunodeficiency 112
MedGen UID:
1841269
Concept ID:
C5830633
Disease or Syndrome
Immunodeficiency-112 (IMD112) is an autosomal recessive primary immunologic disorder with variable manifestations beginning in early childhood. Some patients have recurrent bacterial, viral, and fungal infections, including disseminated bacillus Calmette-Guerin (BCG)-related infections, whereas at least 1 patient only presented with BCG-related infections. Immunologic workup shows variable abnormalities affecting lymphoid immunity, including hypogammaglobulinemia, lymphopenia or paradoxical lymphocytosis, and defects in B, T, and NK cell differentiation and function mainly due to disruption of the noncanonical NFKB (see 164011) signaling pathway (Willmann et al., 2014; Schlechter et al., 2017).
Immunodeficiency 118
MedGen UID:
1852539
Concept ID:
C5882665
Disease or Syndrome
X-linked recessive immunodeficiency-118 (IMD118) is characterized by increased susceptibility to the development of disseminated mycobacterial infections in infancy, notably after BCG vaccination. Affected males usually recover with treatment, have no other infections, and show normal growth and development. Immunologic workup shows normal numbers of circulating leukocyte subsets, but functional studies show impaired JAK2 (147796) translation in certain T lymphocytes, resulting in defective IL23 (see 605580)-dependent induction of IFNG (147570) production and secretion from other immune cells (Bohlen et al., 2023).
Immunodeficiency 117
MedGen UID:
1848763
Concept ID:
C5882739
Disease or Syndrome
Immunodeficiency-117 (IMD117) is an autosomal recessive immunologic disorder characterized by increased susceptibility to disseminated mycobacterial infection apparent in early childhood. Affected individuals develop mycobacterial disease after BCG (bacille Calmette-Guerin) vaccination and show increased susceptibility to other mycobacterial infections, such as M. avium. Immunologic workup shows impaired development of myeloid and lymphoid cell subsets that secrete and respond to gamma-interferon (IFNG; 147570) (et al., 2023).

Professional guidelines

PubMed

Soyak Aytekin E, Keskin A, Tan C, Yalçın E, Dogru D, Ozcelik U, Kiper N, Tezcan I, Cagdas D
Scand J Immunol 2021 Oct;94(4):e13084. Epub 2021 Jul 28 doi: 10.1111/sji.13084. PMID: 34780073
Cabas P, Rizzo M, Giuffrè M, Antonello RM, Trombetta C, Luzzati R, Liguori G, Di Bella S
Urol Oncol 2021 Feb;39(2):85-92. Epub 2020 Dec 8 doi: 10.1016/j.urolonc.2020.11.037. PMID: 33308969
Guerrero-Ramos F, Lara-Isla A, Justo-Quintas J, Duarte-Ojeda JM, de la Rosa-Kehrmann F, Villacampa-Aubá F
Actas Urol Esp 2017 Nov;41(9):590-595. Epub 2017 Apr 28 doi: 10.1016/j.acuro.2017.03.003. PMID: 28457495

Recent clinical studies

Etiology

Joseph A, Lafarge A, Mabrouki A, Abdel-Nabey M, Binois Y, Younan R, Azoulay E
Curr Opin Crit Care 2022 Oct 1;28(5):540-550. Epub 2022 Aug 10 doi: 10.1097/MCC.0000000000000978. PMID: 35950720
Soyak Aytekin E, Keskin A, Tan C, Yalçın E, Dogru D, Ozcelik U, Kiper N, Tezcan I, Cagdas D
Scand J Immunol 2021 Oct;94(4):e13084. Epub 2021 Jul 28 doi: 10.1111/sji.13084. PMID: 34780073
Takikawa H, Ae R, Matsubara Y, Matsubara D, Makino N, Kosami K, Kuwabara M, Sasahara T, Nakamura Y
Arch Dis Child 2021 Jul;106(7):669-673. Epub 2020 Dec 10 doi: 10.1136/archdischild-2020-319543. PMID: 33303488
Ying W, Sun J, Liu D, Hui X, Yu Y, Wang J, Wang X
PLoS One 2014;9(4):e94485. Epub 2014 Apr 10 doi: 10.1371/journal.pone.0094485. PMID: 24722620Free PMC Article
Barbaud A, Deschildre A, Waton J, Raison-Peyron N, Tréchot P
Eur J Dermatol 2013 Apr 1;23(2):135-41. doi: 10.1684/ejd.2012.1842. PMID: 23238161

Diagnosis

Lyra PT, Souza E, Moura ACA, Matta MC, Torres LC, Coelho AVC, Rocha MÂW, Arraes L, Oliveira JB
J Clin Immunol 2022 Nov;42(8):1708-1720. Epub 2022 Jul 30 doi: 10.1007/s10875-022-01302-9. PMID: 35907101
Soyak Aytekin E, Keskin A, Tan C, Yalçın E, Dogru D, Ozcelik U, Kiper N, Tezcan I, Cagdas D
Scand J Immunol 2021 Oct;94(4):e13084. Epub 2021 Jul 28 doi: 10.1111/sji.13084. PMID: 34780073
Takikawa H, Ae R, Matsubara Y, Matsubara D, Makino N, Kosami K, Kuwabara M, Sasahara T, Nakamura Y
Arch Dis Child 2021 Jul;106(7):669-673. Epub 2020 Dec 10 doi: 10.1136/archdischild-2020-319543. PMID: 33303488
Lynch M, O'Loughlin A, Devaney D, O'Donnell B
Pediatr Dermatol 2014 Nov-Dec;31(6):750-1. Epub 2012 Dec 18 doi: 10.1111/pde.12036. PMID: 23253103
Barbaud A, Deschildre A, Waton J, Raison-Peyron N, Tréchot P
Eur J Dermatol 2013 Apr 1;23(2):135-41. doi: 10.1684/ejd.2012.1842. PMID: 23238161

Therapy

Joseph A, Lafarge A, Mabrouki A, Abdel-Nabey M, Binois Y, Younan R, Azoulay E
Curr Opin Crit Care 2022 Oct 1;28(5):540-550. Epub 2022 Aug 10 doi: 10.1097/MCC.0000000000000978. PMID: 35950720
Soyak Aytekin E, Keskin A, Tan C, Yalçın E, Dogru D, Ozcelik U, Kiper N, Tezcan I, Cagdas D
Scand J Immunol 2021 Oct;94(4):e13084. Epub 2021 Jul 28 doi: 10.1111/sji.13084. PMID: 34780073
Takikawa H, Ae R, Matsubara Y, Matsubara D, Makino N, Kosami K, Kuwabara M, Sasahara T, Nakamura Y
Arch Dis Child 2021 Jul;106(7):669-673. Epub 2020 Dec 10 doi: 10.1136/archdischild-2020-319543. PMID: 33303488
Yamazaki-Nakashimada MA, Unzueta A, Berenise Gámez-González L, González-Saldaña N, Sorensen RU
Hum Vaccin Immunother 2020 Aug 2;16(8):1841-1850. Epub 2020 Jan 29 doi: 10.1080/21645515.2019.1706930. PMID: 31995448Free PMC Article
Barbaud A, Deschildre A, Waton J, Raison-Peyron N, Tréchot P
Eur J Dermatol 2013 Apr 1;23(2):135-41. doi: 10.1684/ejd.2012.1842. PMID: 23238161

Prognosis

Azarsiz E, Karaca N, Karaca E, Aksu G, Genel F, Gulez N, Ozen S, Kutukculer N
Asian Pac J Allergy Immunol 2023 Dec;41(4):372-378. doi: 10.12932/AP-271219-0726. PMID: 33638623
Guerrero-Ramos F, Lara-Isla A, Justo-Quintas J, Duarte-Ojeda JM, de la Rosa-Kehrmann F, Villacampa-Aubá F
Actas Urol Esp 2017 Nov;41(9):590-595. Epub 2017 Apr 28 doi: 10.1016/j.acuro.2017.03.003. PMID: 28457495
Ying W, Sun J, Liu D, Hui X, Yu Y, Wang J, Wang X
PLoS One 2014;9(4):e94485. Epub 2014 Apr 10 doi: 10.1371/journal.pone.0094485. PMID: 24722620Free PMC Article
Gantzer A, Neven B, Picard C, Brousse N, Lortholary O, Fischer A, Bodemer C, Fraitag S
J Cutan Pathol 2013 Jan;40(1):30-7. Epub 2012 Nov 12 doi: 10.1111/cup.12048. PMID: 23157280
Onal IK, Ersoy O, Aydinli M, Yonem O, Harmanci O, Sokmensuer C, Bayraktar Y
Eur J Intern Med 2008 Nov;19(7):527-30. Epub 2008 Mar 11 doi: 10.1016/j.ejim.2008.01.012. PMID: 19013382

Clinical prediction guides

Cabas P, Rizzo M, Giuffrè M, Antonello RM, Trombetta C, Luzzati R, Liguori G, Di Bella S
Urol Oncol 2021 Feb;39(2):85-92. Epub 2020 Dec 8 doi: 10.1016/j.urolonc.2020.11.037. PMID: 33308969
Kutluğ Ş, Şensoy G, Birinci A, Saraymen B, Yavuz Köker M, Yιldιran A
Asian Pac J Allergy Immunol 2018 Mar;36(1):35-41. doi: 10.12932/AP0859. PMID: 28577521
Khan TA, Mazhar H, Nawaz M, Kalsoom K, Ishfaq M, Asif H, Rahman H, Qasim M, Naz F, Hussain M, Khattak B, Ullah W, Cabral-Marques O, Butt J, Iqbal A
Microb Pathog 2017 Jan;102:160-165. Epub 2016 Nov 30 doi: 10.1016/j.micpath.2016.11.025. PMID: 27914961
Kutukculer N, Gulez N, Karaca NE, Aksu G, Berdeli A
Ital J Pediatr 2012 Mar 16;38:8. doi: 10.1186/1824-7288-38-8. PMID: 22424479Free PMC Article
Steg A, Leleu C, Debré B, Boccon-Gibod L, Sicard D
Eur Urol 1989;16(3):161-4. doi: 10.1159/000471561. PMID: 2744050

Recent systematic reviews

Cabas P, Rizzo M, Giuffrè M, Antonello RM, Trombetta C, Luzzati R, Liguori G, Di Bella S
Urol Oncol 2021 Feb;39(2):85-92. Epub 2020 Dec 8 doi: 10.1016/j.urolonc.2020.11.037. PMID: 33308969
Fekrvand S, Yazdani R, Olbrich P, Gennery A, Rosenzweig SD, Condino-Neto A, Azizi G, Rafiemanesh H, Hassanpour G, Rezaei N, Abolhassani H, Aghamohammadi A
J Allergy Clin Immunol Pract 2020 Apr;8(4):1371-1386. Epub 2020 Jan 30 doi: 10.1016/j.jaip.2020.01.038. PMID: 32006723
Hassanzad M, Valinejadi A, Darougar S, Hashemitari SK, Velayati AA
Adv Respir Med 2019;87(4):239-242. doi: 10.5603/ARM.2019.0040. PMID: 31476012

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