ArticleCureus2025
A Case of Pulmonary Hemorrhage, Supratherapeutic International Normalized Ratio (INR), and Anti-neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: Unmasking a Potential Link to Tirzepatide.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
1 citing paper in PubMed.
- Tirzepatide for obesity without diabetes: mechanistic insights, clinical evidence, and future directions.Frontiers in pharmacology · 2026Review
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1RAs), such as tirzepatide (Mounjaro), are widely used for type 2 diabetes and obesity, but their effects on drug metabolism and immune regulation remain areas of concern. We report a 64-year-old male with diabetes and chronic deep vein thrombosis (DVT) on warfarin who developed pulmonary hemorrhage, acute kidney injury (AKI), and markedly elevated cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) levels shortly after increasing his tirzepatide dose. His international normalized ratio (INR) was supratherapeutic at 8.7, prompting warfarin discontinuation. Despite INR normalization, he developed diffuse alveolar hemorrhage (DAH) and worsening renal function. Workup revealed ANCA-associated vasculitis, though confirmation by renal biopsy was pending at the time of the patient's expiration. He required corticosteroids, plasmapheresis, rituximab, and hemodialysis. This case highlights potential pharmacokinetic interactions between tirzepatide and warfarin, as well as a possible role for tirzepatide in triggering autoimmunity. While definitive causality remains unclear, clinicians should closely monitor INR levels in patients on GLP-1RAs and warfarin and be vigilant for autoimmune complications in those presenting with pulmonary-renal syndromes. Further research is needed to explore the immunomodulatory effects of tirzepatide.
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Registered trials
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