Portal vein thrombosis in a patient on semaglutide

Feb 10, 2025Qatar medical journal

Portal vein blood clot in a patient taking semaglutide

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Abstract

A 59-year-old woman with type 2 diabetes experienced intrahepatic portal vein thrombosis after six months of treatment with the glucagon-like peptide-1 receptor agonist semaglutide.

Semaglutide is associated with weight reduction and improved glycemic control in patients with type 2 diabetes.
The patient presented with low back pain, nausea, and poor oral intake, which led to further investigation.
Abdominal imaging revealed intrahepatic portal vein thrombosis without liver cirrhosis or malignancy.
Mild leukocytosis and neutrophilia were observed during examination, but no significant findings were noted otherwise.
A negative thrombophilia examination was reported, except for a Janus kinase 2 mutation, which may elevate thrombosis risk.
Increased use of GLP1-RA for weight loss highlights the need for awareness of potential thrombotic risks.

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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 tbl2DM and obesity, but can be associated with an increased risk of venous thromboembolism.This case report describes a 59-year-old woman with tbl2DM 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. Background: Case presentation: Conclusions:

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Portal vein thrombosis in a patient on semaglutide

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