1887
Volume 2025, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

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.

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2025-06-30
2026-01-14

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References

  1. Weir CB, Jan A. BMI classification percentile and cut off points. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2023.
    [Google Scholar]
  2. Consultation WHOE. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. (2004) 363:: 157–63. https://doi.org/10.1016/S0140-6736(03)15268-3
    [Google Scholar]
  3. Drucker DJ. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metab. 2018; 27:: 740–56.
    [Google Scholar]
  4. Knudsen LB, Lau J. The discovery and development of liraglutide and semaglutide. Front Endocrinol (Lausanne). 2019; 10:: 155.
    [Google Scholar]
  5. Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, et al.. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomized, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021 397:: 971–84. https://doi.org/10.1016/S0140-6736(21)00213-0
    [Google Scholar]
  6. Shukla A, Giri S. Portal vein thrombosis in cirrhosis. J Clin Exp Hepatol. 2022; 12::965–79.
    [Google Scholar]
  7. Valla DC, Condat B, Lebrec D. Spectrum of portal vein thrombosis in the West. J Gastroenterol Hepatol. 2002; 17:(Suppl. S3): S224–7.
    [Google Scholar]
  8. Amitrano L, Guardascione MA, Brancaccio V, Margaglione M, Manguso F, Iannaccone L, et al.. Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J. Hepatol. 2004; 40::736–41.
    [Google Scholar]
  9. Intagliata NM, Caldwell SH, Tripodi A. Diagnosis, development, and treatment of portal vein thrombosis in patients with and without cirrhosis. Gastroenterology. 2019; 156::1582–99.e1.
    [Google Scholar]
  10. Plessier A, Darwish-Murad S, Hernandez-Guerra M, Consigny Y, Fabris F, Trebicka J, et al.. Acute portal vein thrombosis unrelated to cirrhosis: a prospective multicenter follow-up study. Hepatology. 2010; 51::210–8.
    [Google Scholar]
  11. Valla D, Casadevall N, Huisse MG, Tulliez M, Grange JD, Muller O, et al.. Etiology of portal vein thrombosis in adults. A prospective evaluation of primary myeloproliferative disorders. Gastroenterology. 1988; 94::1063–9.
    [Google Scholar]
  12. Giri S, Angadi S, Varghese J, Sundaram S, Bhrugumalla S. Prothrombotic states in portal vein thrombosis and Budd-Chiari syndrome in India: a systematic review and meta-analysis. Indian J Gastroenterol. 2023; 42::629–41.
    [Google Scholar]
  13. Guy A, Gourdou-Latyszenok V, Le Lay N, Peghaire C, Kilani B, Dias JV, et al.. Vascular endothelial cell expression of JAK2(V617F) is sufficient to promote a pro-thrombotic state due to increased P-selectin expression. Haematologica. 2019; 104::70–81.
    [Google Scholar]
  14. Kumar N, Sharma S, Binota J, Ahluwalia J, Varma N, Naseem S, et al.. JAK2V617F mutation in patient with splanchnic vein thrombosis. Indian J Hematol Blood Transfus. 2020; 36::700–4.
    [Google Scholar]
  15. Yonal I, Pinarbası B, Hindilerden F, Hancer VS, Nalcaci M, Kaymakoglu S, et al.. The clinical significance of JAK2V617F mutation for Philadelphia-negative chronic myeloproliferative neoplasms in patients with splanchnic vein thrombosis. J Thromb Thrombolysis. 2012; 34::388–96.
    [Google Scholar]
  16. Yang G, Staercke CD, Hooper WC. The effects of obesity on venous thromboembolism: a review. Open J Prev Med. 2012; 2::49.
    [Google Scholar]
  17. Yin DG, Ding LL, Zhou HR, Qiu M, Duan XY. Comprehensive analysis of the safety of semaglutide in type 2 diabetes: a meta-analysis of the SUSTAIN and PIONEER trials. Endocr J. 2021; 68:(6):739–42.
    [Google Scholar]
  18. Manuel SL, Lin F, Kutty SM. An atypical presentation of dulaglutide-induced pancreatitis complicated by superior mesenteric vein thrombosis. Cureus. 2023; 15:(12):e50051. https://doi.org/10.7759/cureus.50051
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): Obesitysemaglutidethrombophiliatype 2 diabetes mellitusvenous thromboembolism and weight loss
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