Sitagliptin induced acute pancreatitis: Case report and brief review of literature

Background:
Sitagliptin phosphate is a dipeptidyl peptidase IV (DPP-IV) inhibitor used as oral hypoglycemic agent in the treatment of type 2 Diabetes Mellitus. Features of drug induced pancreatitis are temporal sequence, known response pattern and reversible when drug is withdrawn. Acute pancreatitis is a rare known complication of sitagliptin, which can occur at any time after initiation of the drug therapy.
Case summary:
A 32-year old man was presented in medical casualty with acute pain in abdomen. He was a case of T2DM taking tablet of sitagliptin 100 mg/day since last one year. Patient was obese, nonsmoker and not alcoholic. Diagnostic laboratory work up showed glycosylated hemoglobin 6.7%, raised levels of serum amylase (109 u/l Normal range 28-90 U/L) and Lipase (174 U/L Normal range- 0-64 U/L), which favored diagnosis of acute pancreatitis. We stopped his tablet sitagliptin and shifted him to insulin and metformin. Symptomatic treatment was offered and he improved clinically and discharged from the hospital.
Conclusion:
Acute pancreatitis among patients receiving sitagliptin is a rare entity. But physicians should always keep the possibility of sitagliptin-induced pancreatitis during follow up of the patients. Cautious monitoring for development of signs and symptoms of acute pancreatitis in patients receiving sitagliptin is important in long-term management.