Supplementary Material for: Enfortumab vedotin-induced diabetic ketoacidosis and acute tubulointerstitial nephritis requiring intensive care in the treatment of advanced urothelial carcinoma: a case report

Enfortumab vedotin (EV) has been approved for the treatment of many types of cancer, and its use is still expanding. It is an essential drug used as a standard treatment for advanced and metastatic urothelial carcinoma, but is known to cause various adverse events. We report a patient with metastatic urothelial carcinoma who experienced multiple adverse events associated with diabetic ketoacidosis (DKA) during EV treatment. The onset of DKA during EV treatment has been reported to be associated with poor prognosis. Although strict management was required in the intensive care unit, we were able to save his life. We report on the pathogenesis and management of drug-induced diabetic ketoacidosis caused by EV based on our case and a literature review.

恩福妥单抗维多汀（Enfortumab vedotin, EV）已获批用于多种恶性肿瘤的治疗，其临床应用场景仍在持续拓展。该药作为晚期及转移性尿路上皮癌的标准治疗核心用药，已知可引发多种不良反应。本文报告1例转移性尿路上皮癌患者在接受EV治疗期间，出现与糖尿病酮症酸中毒（diabetic ketoacidosis, DKA）相关的多类不良反应。据现有文献报道，EV治疗期间发生糖尿病酮症酸中毒往往提示不良预后。尽管该患者需在重症监护病房接受严格的诊疗管理，但最终成功挽回其生命。本文结合本例病例及相关文献复习，对EV所致药物性糖尿病酮症酸中毒的发病机制与临床管理策略进行系统阐述。