1887
Volume 2024, Issue 4
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

ملخص

Obesity and type 2 diabetes mellitus (T2DM) are modern-day pandemics that have a significant impact on global healthcare. The glucagon-like peptide-1 receptor agonist (GLP1-RA) semaglutide is a novel treatment for both T2DM and obesity, but can be associated with an increased risk of venous thromboembolism.

This case report describes a 59-year-old woman with T2DM who received semaglutide to manage glycemic levels, and also experienced the additional benefit of weight reduction. Within six months of initiating GLP1-RA, the patient experienced low back pain associated with nausea and poor oral intake. She had no known risk factors for venous thromboembolism or thrombophilia and had no history of significant illness in her family. Her physical examination revealed no significant findings. Only mild leukocytosis and neutrophilia were noted. She underwent an abdominal computed tomography scan, which revealed intrahepatic portal vein thrombosis without evidence of liver cirrhosis or abdominal malignancy. Her symptoms improved with oral anticoagulation (rivaroxaban). The result of thrombophilia examination was negative for inherited or acquired thrombophilia, except for a Janus kinase 2 mutation, which may increase the risk of thrombosis.

The use of GLP1-RA is increasing due to the growing desire for weight loss medications. Therefore, it is important that physicians better understand the possible risks of thrombosis before initiating GLP1-RA treatment.

Loading

جارٍ تحميل قياسات المقالة...

/content/journals/10.5339/qmj.2024.75
٢٠٢٤-١٢-٣١
٢٠٢٥-٠١-٠٩
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2024/4/qmj.2024.75.html?itemId=/content/journals/10.5339/qmj.2024.75&mimeType=html&fmt=ahah

References

  1. Weir CB, Jan A. BMI classification percentile and cut off points. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. PMID: 31082114.
    [Google الباحث العلمي]
  2. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004 Jan 10; 363:(9403):157–163. doi: 10.1016/S0140-6736(03)15268-3.
    [Google الباحث العلمي]
  3. Drucker DJ. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metab. 2018 Apr 3; 27:(4):740–756. doi: 10.1016/j.cmet.2018.03.001.
    [Google الباحث العلمي]
  4. Knudsen LB, Lau J. The discovery and development of liraglutide and semaglutide. Front Endocrinol (Lausanne). 2019Apr 12;10:155. doir. doi: 10.3389/fendo.2019.00155.
    [Google الباحث العلمي]
  5. Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomized, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021Mar 13; 397:(10278):971–984. doi: 10.1016/S0140-6736(21)00213-0.
    [Google الباحث العلمي]
  6. Shukla A, Giri S. Portal vein thrombosis in cirrhosis. J Clin Exp Hepatol. 2022May-Jun; 12:(3):965–979. doi: 10.1016/j.jceh.2021.11.003.
    [Google الباحث العلمي]
  7. Valla D-C. Condat B, Lebrec D. Spectrum of portal vein thrombosis in the West. J Gastroenterol Hepatol. 2002Dec; 17:(Suppl. S3):S224–S227. doi: 10.1046/j.1440-1746.17.s3.4.x.
    [Google الباحث العلمي]
  8. Amitrano L, Guardascione MA, Brancaccio V, Margaglione M, Manguso F, Iannaccone L, et al. Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J Hepatol. 2004May; 40:(5):736–741. doi: 10.1016/j.jhep.2004.01.001.
    [Google الباحث العلمي]
  9. Intagliata NM, Caldwell SH, Tripodi A. Diagnosis, development, and treatment of portal vein thrombosis in patients with and without cirrhosis. Gastroenterology. 2019May; 156:(6):1582–1599.e1. doi: 10.1053/j.gastro.2019.01.265.
    [Google الباحث العلمي]
  10. Plessier A, Darwish-Murad S, Hernandez-Guerra M, Consigny Y, Fabris F, Trebicka J. et al. Acute portal vein thrombosis unrelated to cirrhosis: a prospective multicenter follow-up study. Hepatology. 2010Jan; 51:(1):210–218. doi: 10.1002/hep.23259.
    [Google الباحث العلمي]
  11. Valla D, Casadevall N, Huisse MG, Tulliez M, Grange JD, Muller O, et al. Etiology of portal vein thrombosis in adults. A prospective evaluation of primary myeloproliferative disorders. Gastroenterology. 1988Apr; 94:(4):1063–1069. doi: 10.1016/0016-5085(88)90567-7.
    [Google الباحث العلمي]
  12. Giri S, Angadi S, Varghese J, Sundaram S, Bhrugumalla S. Prothrombotic states in portal vein thrombosis and Budd-Chiari syndrome in India: a systematic review and meta-analysis. Ind J Gastroenterol. 2023Oct; 42:(5):629–641. doi: 10.1007/s12664-023-01400-5.
    [Google الباحث العلمي]
  13. Guy A, Gourdou-Latyszenok V, Le Lay N, Peghaire C, Kilani B, Dias JV, et al. Vascular endothelial cell expression of JAK2(V617F) is sufficient to promote a pro-thrombotic state due to increased P-selectin expression. Haematologica. 2019Jan; 104:(1):70–81. doi: 10.3324/haematol.2018.195321.
    [Google الباحث العلمي]
  14. Kumar N, Sharma S, Binota J, Ahluwalia J, Varma N, Naseem, S, et al. JAK2V617F Mutation in Patient with Splanchnic Vein Thrombosis. Ind J Hematol Blood Transfus. 2020Oct; 36:(4):700–704. doi: 10.1007/s12288-020-01292-x.
    [Google الباحث العلمي]
  15. Yonal I, Pinarbası B, Hindilerden F, Hancer VS, Nalcaci M, Kaymakoglu S, et al. The clinical significance of JAK2V617F mutation for Philadelphia-negative chronic myeloproliferative neoplasms in patients with splanchnic vein thrombosis. J Thromb Thrombolysis. 2012Oct; 34:(3):388–396. doi: 10.1007/s11239-012-0738-2.
    [Google الباحث العلمي]
  16. Yang G, Staercke CD, Hooper WC. The effects of obesity on venous thromboembolism: A review. Open J Prev Med. 2012Nov; 2:(4):449–509. doi: 10.4236/ojpm.2012.24069.
    [Google الباحث العلمي]
  17. Yin DG, Ding LL, Zhou HR, Qiu M, Duan XY. Comprehensive analysis of the safety of semaglutide in type 2 diabetes: a meta-analysis of the SUSTAIN and PIONEER trials. Endocr J. 2021Jun 28; 68:(6):739–742. doi: 10.1507/endocrj.EJ21-0129.
    [Google الباحث العلمي]
  18. Manuel SL, Lin F, Kutty SM. An atypical presentation of dulaglutide-induced pancreatitis complicated by superior mesenteric vein thrombosis. Cureus. 2023Dec 6; 15:(12):e50051. doi: 10.7759/cureus.50051.
    [Google الباحث العلمي]
/content/journals/10.5339/qmj.2024.75
Loading
/content/journals/10.5339/qmj.2024.75
Loading

جارٍ تحميل البيانات والوسائط...

  • نوع المستند: Research Article
الموضوعات الرئيسية Obesitysemaglutidethrombophiliatype 2 diabetes mellitusvenous thromboembolism and weight loss

الأكثر اقتباسًا لهذا الشهر Most Cited RSS feed

هذه الخانة مطلوبة
يُرجى إدخال عنوان بريد إلكتروني صالح
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error