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Eosinophilic Panniculitis Following the Subcutaneous Injection of Exenatide Extended-Release

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Exenatide extended-release was recently developed as an antidiabetic drug; it acts as a glucagon-like peptide-1 receptor agonist. A 54-year-old male visited our clinic complaining of a subcutaneous tender nodule on his left thigh that had developed over the course of 1 week. The patient had received exenatide extended-release injections for 5 months to treat diabetes. A histopathologic examination showed septal and lobular panniculitis with lymphohistiocyte and eosinophil infiltration. The patient was diagnosed with eosinophilic panniculitis (EP) due to exenatide extended- release injection. EP is a rare type of panniculitis characterized by a prominent infiltrate of eosinophils in the subcutaneous fat layer. It is a histologic reaction pattern that is associated with various clinical conditions. Among the injection- site reactions reported in exenatide extended-release users, injection-site nodules occur infrequently. Clinicians who treat diabetics who use exenatide extended-release should be aware of the possible occurrence of injection-site nodules.

Abstract

Exenatide extended-release was recently developed as an antidiabetic drug; it acts as a glucagon-like peptide-1 receptor agonist. A 54-year-old male visited our clinic complaining of a subcutaneous tender nodule on his left thigh that had developed over the course of 1 week. The patient had received exenatide extended-release injections for 5 months to treat diabetes. A histopathologic examination showed septal and lobular panniculitis with lymphohistiocyte and eosinophil infiltration. The patient was diagnosed with eosinophilic panniculitis (EP) due to exenatide extended- release injection. EP is a rare type of panniculitis characterized by a prominent infiltrate of eosinophils in the subcutaneous fat layer. It is a histologic reaction pattern that is associated with various clinical conditions. Among the injection- site reactions reported in exenatide extended-release users, injection-site nodules occur infrequently. Clinicians who treat diabetics who use exenatide extended-release should be aware of the possible occurrence of injection-site nodules.

참고문헌 (9)

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  5. DeYoung MB, "Encapsulation of exenatide in poly-(D,L-lactide-co-glycolide)microspheres produced an investigational long-acting once-weekly formulation for type 2 diabetes", Diabetes Technol Ther, 13, pp.1145~1154 (2011)
  6. Shan SJ, "Exenatide-induced eosinophilic sclerosing lipogranuloma at the injection site", Am J Dermatopathol, 36, pp.510~512 (2014)
  7. Andrés-Ramos I, "Exenatide-induced eosinophil-rich granulomatous panniculitis : a novel case showing injected microspheres", Am J Dermatopathol, 37, pp.801~802 (2015)
  8. Vidal CI, "Exenatide-induced panniculitis : utility of the acid-fast stain to identify injected microspheres", Am J Dermatopathol, 40, pp.867~869 (2018)
  9. Boysen NC, "Eosinophil-rich granulomatous panniculitis caused by exenatide injection", J Cutan Pathol, 41, pp.63~65 (2014)

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