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First Reported Case of Dulaglutide-Induced Acute Pancreatitis With Normal Serum Lipase Level
Mohammad Shahbazi1, Zainab Qudsiya1, Aboud Fahel1
1Internal Medicine, St. Luke's Hospital, Chesterfield, USA.
Cureus
|July 19, 2023
Summary
Dulaglutide, used for diabetes and heart failure, can mask acute pancreatitis. Even with normal lipase levels, clinical suspicion warrants imaging to diagnose pancreatitis.
Area of Science:
- Endocrinology
- Gastroenterology
Background:
- Dulaglutide is a glucagon-like peptide-1 receptor agonist widely prescribed for type 2 diabetes and congestive heart failure.
- It is also utilized off-label for weight management.
- The drug's increasing prevalence necessitates understanding its potential impact on diagnostic markers.
Observation:
- A case presented with clinical indicators of acute pancreatitis.
- However, laboratory tests revealed a normal serum lipase level.
- This finding is atypical, as elevated lipase is a hallmark of acute pancreatitis.
Findings:
- The patient's presentation mimicked acute pancreatitis despite a normal lipase.
- This highlights a potential diagnostic challenge associated with dulaglutide use.
- Normal lipase levels do not exclude acute pancreatitis in certain clinical contexts.
Implications:
- Clinicians should maintain a high index of suspicion for acute pancreatitis even with normal lipase when a patient is on dulaglutide.
- Radiological imaging, such as CT scans or MRI, should be considered promptly to confirm or exclude the diagnosis.
- This case underscores the importance of integrating clinical presentation with diagnostic tests, especially when medications can influence laboratory results.
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