Semaglutide-Associated Severe Gastrointestinal Intolerance and Hepatic Granulomas: A Case Report
Semaglutide-associated Hepatic Granulomas
Keywords:
Semaglutide, Ozempic, GLP-1 agonist, semaglutide and hepatic granulomas, GI side effects of Ozempic, GI side effects of semaglutide, rare side effects of semaglutide, rare side effect of OzempicAbstract
Background: Semaglutide (commonly known as Ozempic, Rybelsus, and Wegovy) is a glucagon-like peptide-1 (GLP-1) receptor agonist. It is increasingly prescribed for diabetes and weight loss. While gastrointestinal side effects are well recognized, hepatic granulomas associated with its use have not been reported in the literature.
Case Presentation: A 36-year-old woman without comorbidities developed persistent nausea, early satiety, anorexia, diarrhea, and 5 kg weight loss within 4 weeks of starting semaglutide 0.25 mg weekly. Ultrasound imaging revealed multiple hepatic granulomas. Laboratory, infectious, and autoimmune evaluations were unremarkable. Following drug discontinuation, her symptoms resolved, and repeat imaging showed resolution of granulomas, eliminating the need for biopsy.
Discussion: This case highlights an atypical presentation of severe gastrointestinal intolerance and hepatic granulomas at a very low dose of semaglutide. The temporal association and resolution after withdrawal suggest a drug-induced hypersensitivity reaction or an immune dysfunction associated with its use.
Conclusion: Clinicians should remain alert for unusual adverse effects of semaglutide, even at initiation doses. Imaging and close follow-up are essential in cases with unexplained gastrointestinal symptoms and hepatic abnormalities.
Keywords: Semaglutide, GLP-1 receptor agonist, hepatic granulomas, gastrointestinal adverse effects
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