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

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IJU case reports 📖 저널 OA 100% 2022: 1/1 OA 2025: 9/9 OA 2026: 25/25 OA 2022~2026 2025 Vol.8(5) p. 529-532
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Tanaka Y, Fujimura Y, Morishita K, Kashiwagi Y, Katsuno S, Nagai T

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

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APA Tanaka Y, Fujimura Y, et al. (2025). A Case of Drug-Induced Hypersensitivity Syndrome Caused by Apalutamide.. IJU case reports, 8(5), 529-532. https://doi.org/10.1002/iju5.70085
MLA Tanaka Y, et al.. "A Case of Drug-Induced Hypersensitivity Syndrome Caused by Apalutamide.." IJU case reports, vol. 8, no. 5, 2025, pp. 529-532.
PMID 40909306 ↗
DOI 10.1002/iju5.70085

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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