病例報告及文獻回顧：備思復(Enfortumab vedotin)誘發糖尿病酮酸中毒(DKA)並導致多重器官衰竭－罕見但致命的不良事件

歐弦哲、阮雍順、溫聖辰

高雄醫學大學附設中和院區 泌尿部; 高雄醫學大學

Case report with literature review: Enfortumab vedotin induced DKA with multiple organ failure – a rare but fatal adverse event

Hsien-Che Ou, Yung-Shun Juan, Sheng-Chen Wen

Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;

School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Abstract：

This report presents a case of a patient with bladder urothelial carcinoma who was treated with Enfortumab vedotin (EV) and subsequently developed diabetic ketoacidosis (DKA) after the third cycle treatment, leading to rapid clinical deterioration within a week.

The patient responded to escalating insulin therapy; however, despite resolution of the DKA, he experienced significant complications, including progressive renal failure that required continuous renal replacement therapy and respiratory failure, ultimately resulting in death.

This study also reviews cases of EV-induced DKA from the literature, emphasizing commonalities in patient profiles, timelines of adverse effects, and treatment strategies. The findings underscore the necessity for heightened awareness and improved management approaches for severe side effects associated with EV therapy.