Association Between Pancreatic Cancer and Dipeptidyl Peptidase-4 Inhibitors Use in a Case-Control StudyDipeptidyl peptidase-4 inhibitor is an incretin-based agent used to treat type 2 diabetes mellitus, which has been available in the Taiwan market since 2009.1 Pancreatic cancer was the eighth leading cause of cancer death in Taiwan in 2017.2 At present, no definite evidence is available on the association between pancreatic cancer and dipeptidyl peptidase-4 inhibitors in Taiwan. To evaluate this issue, a population-based case-control study was conducted using the database of the Taiwan National Health Insurance Program with 23 million citizens living in the independent country of Taiwan.
69-Year-Old Woman With Dyspnea and Cough Productive of White SputumA 69-year-old woman was admitted to our institution with progressive dyspnea and cough productive of white sputum. Three months earlier, the patient was hospitalized elsewhere for evaluation of fever, headache, and fatigue. Results of a right temporal artery biopsy were consistent with giant cell arteritis (GCA). She was treated with prednisone (50 mg/d) and initially improved, but after 6 weeks of therapy, she again experienced feelings of malaise. Her erythrocyte sedimentation rate (ESR) remained elevated at 75 mm/h.
65-Year-Old Woman With Shortness of Breath and Dark UrineA 65-year-old previously healthy woman presented to her primary care physician with a 6-week history of increasing dyspnea, accompanied by a dry cough, fatigue, malaise, and poor appetite. Before her initial presentation and the onset of the aforementioned symptoms, she had attributed her illness to an upper respiratory tract infection. She also reported a 1-week history of passing dark urine and had been treated empirically 2 weeks previously with a 3-day course of oral trimethoprim-sulfamethoxazole for presumptive urinary tract infection.
35-Year-Old Woman With Recurrent PalpitationsA 35-year-old woman presented to the outpatient clinic with a 2-week history of episodic palpitations. She noted that each episode was abrupt in onset and would last approximately 1 to 2 hours before abating gradually. She denied chest pain, shortness of breath, and light-headedness and had no history of similar symptoms.
22-Year-Old Woman With Severe Microcytic AnemiaA 22–year-old woman who had no notable previous medical history reported increasing fatigue during the past few months. Her mother noticed that she looked pale and suggested she visit her family physician. Her family and personal histories were noncontributory. Findings on physical examination were remarkable only for pallor. In particular, she had no hepatosplenomegaly or lymphadenopathy.