Farooqi Mohammed F, Khan Maria, Arshad Muhammad, Agha Adnan
Department of Internal Medicine, Tawam Hospital, Al-Ain, United Arab Emirates.
Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
Qatar Med J. 2025 Jun 11;2025(2):57. doi: 10.5339/qmj.2025.57. eCollection 2025.
Obesity and type 2 diabetes mellitus (T2DM) are both modern-day pandemics, significantly impacting worldwide healthcare. The glucagon-like peptide-1 receptor agonist (GLP1-RA) semaglutide is a novel treatment for both T2DM and obesity; however, it can be associated with an increased risk of venous thromboembolism (VTE). This case report describes a 59-year-old woman with T2DM who received semaglutide for the management of glycemic levels and also experienced the additional advantage of weight reduction. Within 6 months of initiating GLP1-RA, the patient presented with lower back pain associated with nausea and poor oral intake. She had no known risk factors for VTE or thrombophilia or any history of significant illness in her family. Her physical examination revealed no significant findings; only mild leukocytosis and neutrophilia were detected. 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 the thrombophilia examination was negative for inherited or acquired thrombophilia, with the exception of mutation of Janus kinase 2, 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 pertinent for physicians to have a better understanding of the possible risks for thrombosis before initiating GLP1-RA treatment.
肥胖症和2型糖尿病（T2DM）都是现代的流行病，对全球医疗保健产生了重大影响。胰高血糖素样肽-1受体激动剂（GLP1-RA）司美格鲁肽是一种治疗T2DM和肥胖症的新型药物；然而，它可能会增加静脉血栓栓塞（VTE）的风险。本病例报告描述了一名59岁的T2DM女性患者，她接受司美格鲁肽治疗以控制血糖水平，同时还获得了体重减轻的额外益处。在开始使用GLP1-RA的6个月内，患者出现了下背部疼痛，并伴有恶心和食欲不振。她没有已知的VTE或血栓形成倾向风险因素，家族中也没有任何重大疾病史。体格检查未发现明显异常；仅检测到轻度白细胞增多和中性粒细胞增多。她接受了腹部计算机断层扫描，结果显示肝内门静脉血栓形成，没有肝硬化或腹部恶性肿瘤的迹象。口服抗凝药（利伐沙班）后她的症状有所改善。除了可能增加血栓形成风险的Janus激酶2突变外，血栓形成倾向检查结果显示遗传性或获得性血栓形成倾向均为阴性。由于对减肥药的需求不断增加，GLP1-RA的使用也在增加；因此，医生在开始GLP1-RA治疗之前更好地了解血栓形成的潜在风险是很有必要的。
