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一例阿帕鲁胺引起的药物性超敏反应综合征病例。

A Case of Drug-Induced Hypersensitivity Syndrome Caused by Apalutamide.

作者信息

Tanaka Yuki, Fujimura Yui, Morishita Koya, Kashiwagi Yuta, Katsuno Satoshi, Nagai Tatsuya

机构信息

Okazaki City Hospital Okazaki Aichi Japan.

出版信息

IJU Case Rep. 2025 Aug 15;8(5):529-532. doi: 10.1002/iju5.70085. eCollection 2025 Sep.

DOI:10.1002/iju5.70085
PMID:40909306
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12408165/
Abstract

INTRODUCTION

Apalutamide, an androgen receptor antagonist for prostate cancer, rarely causes drug-induced hypersensitivity syndrome (DIHS).

CASE PRESENTATION

A 75-year-old male with prostate cancer and multiple bone metastases developed grade 2 rash and grade 3 liver dysfunction according to the Common Terminology Criteria for Adverse Events (CTCAE) 3 weeks after starting apalutamide with a GnRH antagonist, followed by a 3-day fever. Ten days later, symptoms worsened to grade 3 rash and grade 4 liver dysfunction. He met five diagnostic criteria for DIHS. Hormonal therapy was discontinued, and prednisolone plus intravenous immunoglobulin (IVIG) was administered. Fatigue resolved within 2 days, rash by day 6, and liver function improved to grade 2 by day 10. The patient is currently on abiraterone and a GnRH antagonist without adverse events.

CONCLUSION

This report highlights the importance of caution and regular blood tests when using apalutamide owing to the risk of DIHS.

摘要

引言

阿帕鲁胺是一种用于前列腺癌的雄激素受体拮抗剂，很少引起药物性超敏反应综合征（DIHS）。

病例介绍

一名75岁患有前列腺癌并伴有多处骨转移的男性患者，在开始使用阿帕鲁胺联合促性腺激素释放激素（GnRH）拮抗剂3周后，根据不良事件通用术语标准（CTCAE）出现了2级皮疹和3级肝功能障碍，随后出现了3天发热。10天后，症状加重至3级皮疹和4级肝功能障碍。他符合DIHS的五项诊断标准。停用激素治疗，并给予泼尼松龙加静脉注射免疫球蛋白（IVIG）。疲劳在2天内缓解，皮疹在第6天消退，肝功能在第10天改善至2级。该患者目前正在服用阿比特龙和GnRH拮抗剂，未出现不良事件。

结论

本报告强调了由于存在DIHS风险，使用阿帕鲁胺时谨慎并定期进行血液检查的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0310/12408165/2f8d35df7ab2/IJU5-8-529-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0310/12408165/4fe66ea79699/IJU5-8-529-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0310/12408165/ff422f8ae57d/IJU5-8-529-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0310/12408165/2f8d35df7ab2/IJU5-8-529-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0310/12408165/4fe66ea79699/IJU5-8-529-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0310/12408165/ff422f8ae57d/IJU5-8-529-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0310/12408165/2f8d35df7ab2/IJU5-8-529-g003.jpg

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