Liraglutide Induced Acute Pancreatitis and Jaundice in an Elderly Female – Case Report

Dr. Khalid Farooqui, Dr. Hassan Abu Zaid, Dr. Mohammad Khalid Sharif, Dr. Ahmed M A Abdal Hadi, Dr. Farah Farooqui, Dr. Mohammad Riyadh Al Hammamy

Acute pancreatitis is common clinical entity which we come across in our day to day clinical practice, it is defined as acute inflammation of pancreatic gland caused by various etiologies like CBD stone impaction, biliary strictures, systemic disease, alcoholism, major stress like surgeries, trauma including medications (1). It has been classified as mild, moderate and severe pancreatitis depending on the clinical , bio chemical and radiological appearance.(2) We not so commonly encounter acute pancreatitis with few of common anti diabetic medications we prescribe in our clinics like sulphonylurease,DPP4 inhibitors (3,4,5,6). Liraglutide is one the most commonly prescribed medications in management of Type 2 diabetes during recent days. It is a derivative of a human incretin,glucagon-like peptide-1(GLP-1) and it used as a long-actingglucagon-like peptide-1 receptor agonist.(7) Liraglutide binds to the same receptors as does theendogenousmetabolichormoneGLP-1that stimulate insulin secretion. It acts with glucose dependent fashion specially post prandial high glucose levels it causes insulin secretion by incretin effect, delayed gastric emptying and decreases prandial glucagon secretion (8,9). Liraglutide has also been used in the management of Obesity and also has shown beneficial cardio vascular effects during recent clinical trials.(10) The most common reported adverse effects are nausea, vomiting, abdominal discomfort and there are also cases reported with medullary carcinoma of thyroid and few cases of acute pancreatitis.(11) We Report a case of elderly lady DM2 with morbid obesity started on liraglutide developed Acute Pancreatitis and Cholestatic Jaundice , with symptoms resolving clinically as well as biochemically after stopping liraglutide.