An FDG PET/CT scan incidentally detected subclinical pancreatitis in an 83-year-old man taking tirzepatide, a GLP-1 receptor agonist, with no other identifiable cause.
Asymptomatic pancreatitisThe patient had zero symptoms of pancreatitis — it was detected only because a PET scan for an unrelated condition revealed abnormal pancreatic metabolic activity, later confirmed by elevated lipase.
What the researchers found
FDG PET/CT imaging revealed diffuse increased radiotracer uptake throughout the pancreas in a clinically asymptomatic 83-year-old man. Standard CT showed no structural abnormality, but subsequent lipase testing confirmed subclinical pancreatitis. The patient was taking tirzepatide (a dual GIP/GLP-1 receptor agonist), and after excluding other potential causes, the pancreatitis was attributed to this medication.
This case demonstrates that GLP-1 receptor agonist-associated pancreatitis can be entirely subclinical — detectable only through metabolic imaging or laboratory testing, not symptoms.
Why it matters
Pancreatitis is a known but debated risk associated with GLP-1 receptor agonists — medications now taken by millions of people for diabetes and weight loss. This case is notable because the pancreatitis was completely silent (no symptoms), raising the question of how often this occurs undetected. If subclinical pancreatitis is more common than recognized, it could have implications for long-term monitoring of patients on GLP-1 medications.
How the study worked
This is a case report. An 83-year-old man with basal cell carcinoma was referred for 18F-FDG PET/CT staging. The incidental pancreatic finding prompted follow-up lipase measurement. The clinical team reviewed the patient's medication list and medical history to identify potential causes of pancreatitis, ultimately attributing it to tirzepatide after excluding other etiologies.
What this study cannot tell us
As a single case report, this provides the lowest level of clinical evidence and cannot establish causation between tirzepatide and pancreatitis. The patient was elderly (83 years), which is itself a risk factor for pancreatitis. The finding was incidental — no systematic screening was performed. Without larger studies, it is impossible to know how common subclinical pancreatitis is among GLP-1 receptor agonist users.
How to read the evidence
This is a single case report, which represents the lowest tier of clinical evidence. While it provides an important clinical observation, it cannot establish a causal relationship between tirzepatide and pancreatitis. Case reports are hypothesis-generating, not hypothesis-confirming.
When this study was published
Published in 2025, this is a very recent case report reflecting current clinical experience with GLP-1 receptor agonists, which are among the most widely discussed medications in contemporary medicine.
The bigger picture
The safety profile of GLP-1 receptor agonists is under intense scrutiny as their use expands from diabetes to obesity and potentially other conditions. While acute pancreatitis is listed as a rare side effect, the existence of subclinical pancreatitis — inflammation without symptoms — suggests the true incidence of pancreatic effects may be underestimated. This case adds to the body of evidence that clinicians should be aware of when monitoring patients on these widely prescribed peptide medications.
Questions still open
- How common is subclinical pancreatitis among patients taking GLP-1 receptor agonists, and should routine screening be considered?
- Does subclinical pancreatitis progress to symptomatic disease if the medication is continued?
- Are certain GLP-1 receptor agonists more likely to cause pancreatic inflammation than others?
Common questions
Can GLP-1 medications like tirzepatide and semaglutide cause pancreatitis?
Should I get my pancreas checked if I'm taking a GLP-1 medication?
Read the original research
FDG PET/CT Images Demonstrating Subclinical Pancreatitis in a Patient on a GLP-1 Receptor Agonist.
Clinical nuclear medicine, 50(11), 1069-1070
Citation
Lenkov, Robert; Berman, Tyler; Mehmi, Inderjit; Mehta, Pareen. (2025). FDG PET/CT Images Demonstrating Subclinical Pancreatitis in a Patient on a GLP-1 Receptor Agonist.. Clinical nuclear medicine, 50(11), 1069-1070. https://doi.org/10.1097/RLU.0000000000005856