A Rare Case of Tirzepatide-Induced Hepatitis: Causality Assessment With the RUCAM Criteria

Tirzepatide is an effective medication that targets both glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, resulting in weight loss, improved glycemic control, and better cardiovascular and renal outcomes. Despite that, tirzepatide may have unfavorable consequences. Here, we present a woman in her 30s who was started on tirzepatide 3 months before admission. She had right upper quadrant pain and jaundice. Basic tests showed elevated liver enzymes and bilirubin levels. Her acute hepatitis panel and autoimmune work-up were negative. The abdominal ultrasound showed acute hepatitis with no gallbladder stones. We concluded that tirzepatide was most probably the culprit, with a RUCAM (Roussel Uclaf Causality Assessment Method) score of 7.