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Semaglutide-Induced Liver Injury
Harsimran Kalsi1, Samneet Singh Arora2, Kobina Essilfie-Quaye1
1Department of Internal Medicine, University of Central Florida/ HCA Florida North Florida Hospital, Gainesville, FL.
ACG Case Reports Journal
|August 5, 2025
Summary
Semaglutide, used for diabetes and obesity, can rarely cause liver injury. This case and review highlight the importance of monitoring liver function in patients taking this GLP-1 receptor agonist.
Area of Science:
- Hepatology
- Pharmacology
- Endocrinology
Background:
- Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) approved for type 2 diabetes and obesity management.
- While generally safe, rare instances of hepatotoxicity have been anecdotally reported.
- This study investigates a specific case and reviews existing literature on semaglutide-induced liver injury.
Observation:
- A 44-year-old woman experienced elevated liver enzymes after initiating semaglutide for weight loss.
- Discontinuation of semaglutide led to normalization of liver enzymes.
- Reintroduction of the drug resulted in a recurrence of liver enzyme elevation, confirming a causal link.
Findings:
- The case demonstrates a clear association between semaglutide use and drug-induced liver injury (DILI).
- A comprehensive literature review identified other rare cases of semaglutide-related hepatotoxicity.
- The pattern of injury suggests a potential idiosyncratic reaction to the GLP-1 RA.
Implications:
- Clinicians should consider monitoring liver function tests in patients prescribed semaglutide, especially those with risk factors for liver disease.
- This case adds to the understanding of the rare but potential hepatotoxic effects of GLP-1 RAs.
- Further research may elucidate the mechanisms underlying semaglutide-associated liver injury.
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