A Case of Drug-Induced Hypersensitivity Syndrome Caused by Apalutamide

Q4 Medicine

IJU Case Reports Pub Date : 2025-08-15 DOI:10.1002/iju5.70085

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

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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.

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阿帕鲁胺致药物性超敏综合征1例

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综合征（DIHS）。根据不良事件通用术语标准（CTCAE），一名患有前列腺癌和多发性骨转移的75岁男性患者在阿帕鲁胺联合GnRH拮抗剂治疗3周后出现2级皮疹和3级肝功能障碍，随后出现3天发烧。10天后，症状恶化为3级皮疹和4级肝功能障碍。他符合DIHS的五项诊断标准。停止激素治疗，给予强的松龙加静脉注射免疫球蛋白（IVIG）。2天内疲劳消退，第6天出现皮疹，第10天肝功能改善至2级。患者目前正在服用阿比特龙和GnRH拮抗剂，无不良事件。结论：本报告强调了由于DIHS的风险，使用阿帕鲁胺时谨慎和定期血液检查的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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