ACG case reports journalOct 7, 2024

A Rare Case of Liver Injury Possibly Caused by Tirzepatide

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jan 20, 2026

Abstract

A 37-year-old woman with metabolic syndrome experienced elevated liver enzymes associated with tirzepatide use.

Tirzepatide is approved for managing type II diabetes and obesity.
It is the first drug to activate both incretin receptors for these conditions.
Reported benefits include reducing liver fat content.
Despite its established efficacy, this case presents a potential side effect of elevated liver enzymes linked to tirzepatide.

Simplified

Tirzepatide is the first dual incretin glucose-dependent insulinotropic polypeptide/glucagon-like peptide 1 receptor activator approved for the management of type II diabetes mellitus. This drug was also recently approved by the Food and Drug Administration as a management option for patients with obesity. Tirzepatide has been also reported to be beneficial in reducing liver fat content. Although its efficacy is well described in the literature, no cases of tirzepatide-induced hepatotoxicity have been reported. We report a case of a 37-year-old woman with metabolic syndrome who was noted to have elevated liver enzymes secondary to tirzepatide use.

Key numbers

500 U/L

Level Increase

Initial level upon presentation after starting tirzepatide.

261 U/L

Level Increase

Initial level upon presentation after starting tirzepatide.

RUCAM Score

Score indicating the likelihood of .

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A Rare Case of Liver Injury Possibly Caused by Tirzepatide

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