Department of Clinical Laboratory, Peking University First Hospital, Beijing, China
BMJ Case Rep. 2024 May 6;17(5):e257657. doi: 10.1136/bcr-2023-257657.
The use of dulaglutide, a common medication for managing type 2 diabetes, rarely causes elevated pancreatic tumour markers. Here, we report the case of a woman in her mid-60s with diabetes for over 10 years. The patient presented with markedly elevated serum CA19-9 and CA242 levels revealed during a routine health examination despite being asymptomatic. She had been receiving dulaglutide injections for 16 months. Imaging and interventional assessments did not reveal any hepatobiliary, gastrointestinal or pancreatic neoplasm. After excluding alternate diagnoses, the patient was determined to exhibit an adverse reaction to dulaglutide use. Management involved the discontinuation of dulaglutide, which resulted in normalisation of serum CA19-9 and CA242 levels within 6 weeks. This case underscores the importance of discontinuing dulaglutide and monitoring changes in the biomarker levels in asymptomatic patients receiving dulaglutide, rather than immediately resorting to imaging and endoscopic examinations.
使用度拉鲁肽(一种常用于治疗 2 型糖尿病的药物)很少会引起胰腺肿瘤标志物升高。在这里,我们报告了一例 60 多岁的女性,患有糖尿病超过 10 年。该患者在常规体检时发现血清 CA19-9 和 CA242 水平显著升高,但无任何症状。她已经接受了 16 个月的度拉鲁肽注射治疗。影像学和介入评估未发现任何肝胆、胃肠道或胰腺肿瘤。在排除其他诊断后,确定该患者对度拉鲁肽的使用存在不良反应。治疗包括停用度拉鲁肽,6 周内血清 CA19-9 和 CA242 水平恢复正常。本病例强调了在无症状接受度拉鲁肽治疗的患者中,停用度拉鲁肽并监测生物标志物水平变化的重要性,而不是立即进行影像学和内镜检查。