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Systemic Toxicity With Hyperglycemia or Diabetic Ketoacidosis After Enfortumab Vedotin: Single-Center Case Series

Year: 2025

Type: article

Abstract: Enfortumab vedotin (EV) revolutionized management of metastatic urothelial carcinoma. Multiple-organ dysfunction is a rare adverse event associated with EV with unknown mechanisms. We report three cases of unusual EV systemic toxicity with hyperglycemia and/or diabetic ketoacidosis (DKA) shortly after EV administration. The first case demonstrated insulin-resistant DKA requiring large doses of insulin, high C-peptide levels consistent with intact pancreatic β-cell function, cutaneous eruption, and fatal hemodynamic shock. The second case presented with hyperglycemia, symmetrical muscle weakness, and diffuse cutaneous eruption. The third consisted of mild DKA, rash, jaundice, and confusion. We discuss these severe presentations and empirical therapeutic approaches.

Source: Annals of Internal Medicine Clinical Cases

DOI: 10.7326/aimcc.2024.0465

Authors: Mohammad Jad Moussa, Nathaniel R. Wilson, Anindita Ghosh, Meenakshi B. Bhattacharjee, Jonathan L. Curry, Woo Cheal Cho, Anisha B. Patel, Mouhammed Amir Habra, Sonali N. Thosani, Matthew T. Campbell, Arlene O. Siefker-Radtke, Omar Alhalabi, Nupur J. Kikani

Institutions: The University of Texas MD Anderson Cancer Center, University of Michigan, The University of Texas Health Science Center at Houston

Language: English

Topic: Bladder and Urothelial Cancer Treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4410108065

FWCI:

Cites: 19

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Related to: 10