A 57-year-old man developed pancreatitis complicated by a blood clot in a major abdominal vein four months after increasing his dose of the GLP-1 drug dulaglutide.
4 months post-dose increaseThe time between the dulaglutide dose increase and onset of pancreatitis with venous thrombosis in this patient
What the researchers found
A 57-year-old male with type 2 diabetes developed acute pancreatitis complicated by superior mesenteric vein thrombosis approximately four months after a dose increase of dulaglutide (a GLP-1 receptor agonist). The presentation was atypical — only mild abdominal pain without nausea or vomiting — despite imaging revealing an enlarged pancreatic head and mesenteric vein blood clot. Endoscopic ultrasound with biopsies confirmed acute pancreatitis. The patient was treated with heparin anticoagulation and supportive care, and the GLP-1 agonist was discontinued.
Why it matters
With millions of people now taking GLP-1 receptor agonists for diabetes and weight loss, awareness of rare but serious side effects is critical. Pancreatitis is a known potential risk of GLP-1 drugs, but the combination with venous thrombosis and the atypically mild presentation in this case highlights that serious complications can occur with subtle warning signs, especially after dose increases.
How the study worked
This is a clinical case report describing the diagnosis, imaging findings, and management of a single patient who developed pancreatitis with mesenteric vein thrombosis while taking dulaglutide. Diagnosis was confirmed by imaging studies and endoscopic ultrasound with tissue biopsies.
What this study cannot tell us
As a single case report, this cannot establish causation between dulaglutide and the pancreatitis or the venous thrombosis. The temporal association is suggestive but other causes cannot be fully excluded. Case reports provide the lowest level of clinical evidence and serve primarily to alert clinicians to rare possibilities rather than to quantify risk.
How to read the evidence
This is a single case report, the lowest level of clinical evidence. It is valuable for documenting a rare adverse event pattern but cannot establish how commonly this occurs or prove causation.
When this study was published
Published in 2023, this case report is recent and relevant given the rapidly expanding use of GLP-1 receptor agonists for diabetes and obesity management.
The bigger picture
GLP-1 receptor agonists are among the most prescribed drug classes worldwide, and pancreatitis has been a recognized concern since early clinical trials. This case adds to the safety literature by documenting an unusual complication — venous thrombosis secondary to pancreatitis — and highlighting that atypical presentations may delay recognition of serious adverse events in patients on these medications.
Questions still open
- Is there a dose-dependent relationship between GLP-1 receptor agonist therapy and pancreatitis risk?
- How often does GLP-1-associated pancreatitis present with atypically mild symptoms that could delay diagnosis?
- Are there identifiable risk factors that predict which GLP-1 users are more susceptible to pancreatic complications?
Common questions
Can GLP-1 drugs like Ozempic or Trulicity cause pancreatitis?
What made this case unusual compared to typical pancreatitis?
Read the original research
An Atypical Presentation of Dulaglutide-Induced Pancreatitis Complicated by Superior Mesenteric Vein Thrombosis.
Cureus, 15(12), e50051
Citation
Manuel, Sebastian L; Lin, Frank; Kutty, Sinan M. (2023). An Atypical Presentation of Dulaglutide-Induced Pancreatitis Complicated by Superior Mesenteric Vein Thrombosis.. Cureus, 15(12), e50051. https://doi.org/10.7759/cureus.50051