DPP4 and pancreatitis: He was also taking two medications known to be associated with pancreatitis: dipeptidyl peptidase-4 [15] and a sodium-glucose cotransporter-2 inhibitor [16], which could have worsened or triggered his symptoms given the background of undiagnosed hypertriglyceridemia. Although his hypertriglyceridemia was likely long-standing, the normal enzyme levels were less likely due to acute and chronic disease as he never had prior symptoms and there was no evidence of calcification on imaging.