SHM Converge Scientific Abstract ePoster Gallery-Empagliflozin-Induced Pancreatitis: A Case-Report Pattern?

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This document reports a suspected case of <strong>empagliflozin-induced acute pancreatitis</strong> in a <strong>73-year-old woman</strong> with type 2 diabetes, hypertension, hyperlipidemia, and osteoarthritis. She presented with sudden severe left upper quadrant abdominal pain, nausea, and vomiting. She had no history of alcohol use, trauma, or prior pancreatitis. Her medications included empagliflozin, which had been started two months earlier, along with glimepiride, metoprolol, valsartan/hydrochlorothiazide, rosuvastatin, and aspirin.

On admission, she had fever, diffuse abdominal tenderness, a <strong>lipase of 10,000 U/L</strong>, and leukocytosis. Imaging showed severe pancreatitis with ileus; gallbladder, bile ducts, triglycerides, and MRCP findings did not suggest a common alternative cause. Despite standard treatment with bowel rest, IV fluids, pain control, and NG decompression, she worsened over several days with persistent fever, rising white blood cell count, and repeat CT showing worsening necrotizing pancreatitis. She was treated briefly with broad-spectrum antibiotics, although blood cultures were negative. Due to poor tolerance of gastric feeds, an NJ tube was placed for trickle feeding. Her condition improved slowly, and she was eventually advanced to a clear liquid diet and then regular diet before discharge.

The authors argue that empagliflozin was the most likely trigger because it was the only major recent medication change. They note, however, that <strong>hydrochlorothiazide</strong> is another drug known to be associated with pancreatitis, though less favored as the cause in this case. The report adds to a growing number of case reports suggesting a possible association between <strong>SGLT2 inhibitors, especially empagliflozin, and acute pancreatitis</strong>, and it emphasizes the need for clinician awareness and further study.

Asset Subtitle

Parker Foster

Meta Tag

Author List Parker Foster, Sarbagya Pandit

Category Clinical Vignettes

Concept Acute Pancreatitis

Concept Drug-Induced Pancreatitis

Concept Abdominal Pain

Concept Lipase

Concept Pancreatic Necrosis

Distinguished Non-Finalist

Presenter Organization Medical College of Wisconsin

Presenting Author Parker Foster

Track Adult

Keywords

empagliflozin

acute pancreatitis

SGLT2 inhibitor

necrotizing pancreatitis

type 2 diabetes

hydrochlorothiazide

lipase

abdominal pain

case report

drug-induced pancreatitis

Acute Pancreatitis

Drug-Induced Pancreatitis

Abdominal Pain

Lipase

Pancreatic Necrosis