Enfortumab Vedotin–Induced Toxic Epidermal Necrolysis in Metastatic Urothelial Carcinoma Complicated by Severe Gastrointestinal Bleeding

ABSTRACT Introduction Enfortumab vedotin (EV) has been reported to cause skin toxicity in some patients. We report a rare case of toxic epidermal necrolysis (TEN) induced by EV and complicated by severe gastrointestinal (GI) bleeding. Case Presentation A 70‐year‐old man with recurrent urothelial car...

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Main Authors: Aika Matsuyama, Takashi Kato, Rion Kawase, Mikinori Kobayashi, Ayako Momota, Yukiko Tsunoda, Asaomi Yamaguchi, Hiroki Hirabayashi, Shoji Suzuki, Masashi Kato
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:IJU Case Reports
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Online Access:https://doi.org/10.1002/iju5.70036
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author Aika Matsuyama
Takashi Kato
Rion Kawase
Mikinori Kobayashi
Ayako Momota
Yukiko Tsunoda
Asaomi Yamaguchi
Hiroki Hirabayashi
Shoji Suzuki
Masashi Kato
author_facet Aika Matsuyama
Takashi Kato
Rion Kawase
Mikinori Kobayashi
Ayako Momota
Yukiko Tsunoda
Asaomi Yamaguchi
Hiroki Hirabayashi
Shoji Suzuki
Masashi Kato
author_sort Aika Matsuyama
collection DOAJ
description ABSTRACT Introduction Enfortumab vedotin (EV) has been reported to cause skin toxicity in some patients. We report a rare case of toxic epidermal necrolysis (TEN) induced by EV and complicated by severe gastrointestinal (GI) bleeding. Case Presentation A 70‐year‐old man with recurrent urothelial carcinoma developed a trunk rash at 16 days after EV administration. He presented to the emergency department with loss of consciousness and was diagnosed with TEN and septic shock. Although pulse steroid therapy improved his skin lesions, his abdominal symptoms progressively worsened. On Day 27, he developed massive GI bleeding. Despite intensive interventions, he died of multiple organ failure on Day 30. Conclusion This case highlights that Stevens–Johnson syndrome/TEN induced by EV can develop shortly after treatment, with delayed and potentially fatal GI manifestations. Given the challenges in managing established TEN, close monitoring for adverse events is essential.
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spelling doaj-art-5c25dd51abff4b498a48e841a3e4d7852025-08-20T02:38:09ZengWileyIJU Case Reports2577-171X2025-07-018434835110.1002/iju5.70036Enfortumab Vedotin–Induced Toxic Epidermal Necrolysis in Metastatic Urothelial Carcinoma Complicated by Severe Gastrointestinal BleedingAika Matsuyama0Takashi Kato1Rion Kawase2Mikinori Kobayashi3Ayako Momota4Yukiko Tsunoda5Asaomi Yamaguchi6Hiroki Hirabayashi7Shoji Suzuki8Masashi Kato9Department of Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanDepartment of Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanDepartment of Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanDepartment of Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanDepartment of Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanDepartment of Female Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanDepartment of Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanDepartment of Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanDepartment of Female Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanDepartment of Urology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital Nagoya JapanABSTRACT Introduction Enfortumab vedotin (EV) has been reported to cause skin toxicity in some patients. We report a rare case of toxic epidermal necrolysis (TEN) induced by EV and complicated by severe gastrointestinal (GI) bleeding. Case Presentation A 70‐year‐old man with recurrent urothelial carcinoma developed a trunk rash at 16 days after EV administration. He presented to the emergency department with loss of consciousness and was diagnosed with TEN and septic shock. Although pulse steroid therapy improved his skin lesions, his abdominal symptoms progressively worsened. On Day 27, he developed massive GI bleeding. Despite intensive interventions, he died of multiple organ failure on Day 30. Conclusion This case highlights that Stevens–Johnson syndrome/TEN induced by EV can develop shortly after treatment, with delayed and potentially fatal GI manifestations. Given the challenges in managing established TEN, close monitoring for adverse events is essential.https://doi.org/10.1002/iju5.70036enfortumab vedotingastrointestinal bleedingtoxic epidermal necrolysisurothelial carcinoma
spellingShingle Aika Matsuyama
Takashi Kato
Rion Kawase
Mikinori Kobayashi
Ayako Momota
Yukiko Tsunoda
Asaomi Yamaguchi
Hiroki Hirabayashi
Shoji Suzuki
Masashi Kato
Enfortumab Vedotin–Induced Toxic Epidermal Necrolysis in Metastatic Urothelial Carcinoma Complicated by Severe Gastrointestinal Bleeding
IJU Case Reports
enfortumab vedotin
gastrointestinal bleeding
toxic epidermal necrolysis
urothelial carcinoma
title Enfortumab Vedotin–Induced Toxic Epidermal Necrolysis in Metastatic Urothelial Carcinoma Complicated by Severe Gastrointestinal Bleeding
title_full Enfortumab Vedotin–Induced Toxic Epidermal Necrolysis in Metastatic Urothelial Carcinoma Complicated by Severe Gastrointestinal Bleeding
title_fullStr Enfortumab Vedotin–Induced Toxic Epidermal Necrolysis in Metastatic Urothelial Carcinoma Complicated by Severe Gastrointestinal Bleeding
title_full_unstemmed Enfortumab Vedotin–Induced Toxic Epidermal Necrolysis in Metastatic Urothelial Carcinoma Complicated by Severe Gastrointestinal Bleeding
title_short Enfortumab Vedotin–Induced Toxic Epidermal Necrolysis in Metastatic Urothelial Carcinoma Complicated by Severe Gastrointestinal Bleeding
title_sort enfortumab vedotin induced toxic epidermal necrolysis in metastatic urothelial carcinoma complicated by severe gastrointestinal bleeding
topic enfortumab vedotin
gastrointestinal bleeding
toxic epidermal necrolysis
urothelial carcinoma
url https://doi.org/10.1002/iju5.70036
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