Farmacovigilanza SIF > Sezioni > Casi clinici > Casi clinici dalla letteratura > Fascite eosinofila indotta da semaglutide

Fascite eosinofila indotta da semaglutide

A cura di Alessandra Russo. Specialista in Tossicologia Medica. Messina

  

Caso clinico (1)

Una donna di 42 anni aveva iniziato a manifestare mialgia associata a edema agli arti due settimane dopo aver iniziato un trattamento con semaglutide per via sottocutanea al fine di perdere peso.

Alla visita la frequenza cardiaca era 75 battiti/minuto, la pressione 105/70 mmHg e la frequenza respiratoria 18 atti/minuto.

Gli esami di laboratorio evidenziarono una positività agli anticorpi antiperossidasi tiroidea e livelli elevati di IgE.

Venne effettuata una risonanza agli arti inferiori, che mostrò la presenza di un ispessimento lineare diffuso.

Fu fatta diagnosi di fascite eosinofila.

 

Il trattamento con semaglutide venne interrotto e la paziente venne trattata con metilprednisolone.

Nelle settimane successive si verificò una risoluzione completa dei sintomi, con normalizzazione della conta eosinofila e scomparsa dell’edema agli arti.

Una risonanza magnetica effettuata 4 mesi dopo evidenziò un netto miglioramento.

 

Le reazioni avverse più spesso riportate nei pazienti trattati con agonisti del recettore del glucagone-like peptide-1 (GLP-1), come la semaglutide, includono nausea, vomito e diarrea (2).

Raramente sono stati segnalati casi di pancreatite, insufficienza renale acuta e ipoglicemia (3-5).

Inoltre, sono stati riportati casi isolati di reazioni eosinofile (6-24).

 

Bibliografia

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  3. Steinberg WM, Buse JB, Ghorbani MLM, Ørsted DD, Nauck MA, Steering Committee LEADER, Trial Investigators LEADER. Amylase, lipase, and acute pancreatitis in people with type 2 diabetes treated with liraglutide: results from the LEADER randomized trial. Diabetes Care 2017; 40: 966–972.
  4. Filippatos TD, Elisaf MS. Effects of glucagon-like peptide-1 receptor agonists on renal function. World J Diabetes 2013; 4: 190–201.
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  8. Collins MK, et al. Bullous pemphigoid triggered by liraglutide. Cutis 2021; 107: E9–E11.
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  19. Neahusan E, et al. Autoimmune hepatitis-like drug injury of the liver associated with the glucagon-like peptide 1 (GLP-1) agonist dulaglutide. Am J Gastroenterol 2021; 116: S1189.
  20. Vidal CI, et al. Exenatide-induced panniculitis: utility of the acid-fast stain to identify injected microspheres. Am J Dermatopathol 2018; 40: 867–869.
  21. Riswold K, Flynn V. Persistent injection site nodules from exenatide: successful treatment with intralesional triamcinolone. JAAD Case Rep 2018; 4: 830–832.
  22. Askin C, et al. Acute eosinophilic pneumonia due to extended-release exenatide. Am J Respir Crit Care Med 2017; 195: A5566.
  23. Cogen AL, et al. Acute photodistributed exanthematous pustulosis associated with liraglutide treatment. JAMA Derm 2019; 155: 1198–1200.
  24. Maor Y, et al. Liraglutide-induced hepatotoxicity. Biomedicines 2021; 9: 106.
Ultimo aggiornamento: 13 ottobre 2023