TY - JOUR T1 - Rapidly Progressive Systemic Sclerosis–associated Interstitial Lung Disease After Intravesical Bacillus Calmette-Guérin Therapy for Early-stage Bladder Cancer JF - The Journal of Rheumatology JO - J Rheumatol SP - 1348 LP - 1349 DO - 10.3899/jrheum.201625 VL - 48 IS - 8 AU - Gonçalo Boleto AU - Jérôme Avouac AU - Yannick Allanore Y1 - 2021/08/01 UR - http://www.jrheum.org/content/48/8/1348.abstract N2 - To the Editor:Despite recent advances in the management of systemic sclerosis–associated interstitial lung disease (SSc-ILD), it remains the most common cause of death and a significant contributor to morbidity.1,2 SSc-ILD is characterized by a wide spectrum of disease courses, with some patients having limited nonprogressive fibrosis, whereas others develop rapid and extensive fibrosis leading to respiratory failure.3 Although the pathogenesis of SSc is still poorly understood, extensive fibrosis can result from an inappropriate chronic inflammatory response to a specific trigger. Toxic air pollutants or infections can shape the immune system toward an immunostimulatory status. Here we report the case of a patient with diffuse cutaneous SSc (dcSSc) who developed rapidly extensive ILD after bacillus Calmette-Guérin (BCG) therapy given for noninvasive bladder cancer.Written informed consent was obtained from the patient and ethics board approval was received (Comité de Protection des Personnes CPP Ile de France III, no. 2008-A00624-51).A 61-year-old woman with dcSSc with speckled antinuclear antibodies and no antigen-specific antibodies presented with aggravating dyspnea. dcSSc had been diagnosed in 2003 with severe skin disease (peak modified Rodnan skin score [mRSS] at 40/51) and was … ER -