{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:02:31Z","timestamp":1789470151103,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Hypersensitivity reactions to glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RAs) are uncommon but clinically significant given their expanding use for obesity and type 2 diabetes. Tirzepatide, a dual GLP\u20101\/glucose\u2010dependent insulinotropic polypeptide (GIP) receptor agonist, and reports of allergic reactions remain limited. We present this case to highlight the diagnostic utility of intradermal testing and supervised drug challenge in confirming drug\u2010specific hypersensitivity and identifying a safe therapeutic alternative within the same drug class. We report a 25\u2010year\u2010old woman with class I obesity (BMI 32.25) who developed hypersensitivity reactions after dose escalation of tirzepatide initiated for weight management. She tolerated 3\u2009months of sequential dose escalations from 2.5\u2009mg through 7.5\u2009mg without adverse reaction, losing approximately 20 lbs. during this period. Following her first 10\u2009mg dose, she developed episodic lip angioedema and generalized urticaria over the subsequent 4\u2009days, without respiratory or gastrointestinal symptoms. Symptoms persisted despite intramuscular diphenhydramine, a 5\u2010day course of prednisone, and two emergency department visits with intravenous steroids, ultimately resolving only after tirzepatide discontinuation. Laboratory evaluation conducted approximately 8\u2009months prior to the reaction, following a separate self\u2010limited episode of lip swelling unrelated to tirzepatide, had demonstrated normal total IgE, normal C1 esterase inhibitor protein and function, and normal complement levels, effectively excluding hereditary and acquired angioedema.\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    urea breath testing obtained, and allergy evaluation (which excluded food and seasonal allergies) was negative. Percutaneous skin testing to tirzepatide was negative; however, intradermal testing at 1:10 dilution was positive (8\u2009mm wheal, 8\u2009mm flare), confirming drug hypersensitivity. Intradermal testing to semaglutide was negative. A supervised subcutaneous challenge with semaglutide 0.25\u2009mg was well tolerated, and the patient was cleared to initiate semaglutide under endocrinology oversight. The patient has since continued semaglutide without recurrence. This case illustrates tirzepatide\u2010specific hypersensitivity and highlights the diagnostic value of intradermal testing and supervised challenge in guiding safe continuation of therapy with alternative GLP\u20101RAs.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.73183","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T09:31:47Z","timestamp":1784712707000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hypersensitivity Reaction to Tirzepatide With Demonstrated Tolerance to Semaglutide: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0408-9587","authenticated-orcid":false,"given":"Cameron","family":"Nejat","sequence":"first","affiliation":[{"name":"Department of Public and Ecosystem Health Cornell University  Ithaca New York USA"},{"name":"New Jersey Medical School, Rutgers Biomedical and Health Sciences  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2665-4327","authenticated-orcid":false,"given":"Robert","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology Weill Cornell Medical College  New York New York City USA"},{"name":"New York Allergy and Sinus Centers  New York New York City USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Addo","sequence":"additional","affiliation":[{"name":"Department of Public and Ecosystem Health Cornell University  Ithaca New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristyl","family":"Cuenca\u2010Sisko","sequence":"additional","affiliation":[{"name":"New York Allergy and Sinus Centers  New York New York City USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Lee\u2010Wong","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology Icahn School of Medicine at Mount Sinai  New York New York City USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13230"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010022\u201001604\u20107"},{"key":"e_1_2_11_4_1","unstructured":"Commissioner O of the FDA \u201cFDA Approves New Medication for Chronic Weight Management \u201d(accessed September 28 2025) 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PHARMACOLOGY \u201d(accessed December 31 2025) https:\/\/www.guidetopharmacology.org\/GRAC\/LigandDisplayForward?ligandId=1132&utm_source=chatgpt.com."},{"key":"e_1_2_11_14_1","unstructured":"\u201cGastric Inhibitory Polypeptide | Ligand Page | IUPHAR\/BPS Guide to PHARMACOLOGY \u201d(accessed December 31 2025) https:\/\/www.guidetopharmacology.org\/GRAC\/LigandDisplayForward?tab=summary&ligandId=3542."},{"key":"e_1_2_11_15_1","volume-title":"StatPearls","author":"Patel T.","year":"2025"},{"key":"e_1_2_11_16_1","unstructured":"\u201cOzempic \u201d(accessed December 31 2025) https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2025\/209637s025lbl.pdf."},{"key":"e_1_2_11_17_1","unstructured":"\u201cMounjaro \u201d(accessed December 31 2025) 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