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Systematic review: Sprue-like enteropathy associated with olmesartan
G Ianiro1, S Bibbò, M Montalto
1Department of Internal Medicine, Division of Internal Medicine and Gastroenterology, School of Medicine and Surgery, A. Gemelli Hospital, Catholic University, Rome, Italy.
Alimentary Pharmacology & Therapeutics
|May 9, 2014
Summary
Olmesartan medication can cause a sprue-like enteropathy, a condition with symptoms like diarrhea and weight loss. Discontinuing olmesartan leads to symptom resolution, suggesting a distinct clinical entity.
Area of Science:
- Gastroenterology
- Pharmacology
- Clinical Medicine
Background:
- A sprue-like enteropathy has been recently associated with olmesartan therapy.
- This condition mimics celiac disease but is drug-induced.
Purpose of the Study:
- To systematically review literature on olmesartan-associated enteropathy.
- To describe three additional cases of this adverse drug reaction.
Main Methods:
- Conducted comprehensive literature searches (electronic and manual).
- Included case reports and series due to limited large-scale studies.
- Two independent reviewers extracted data.
Main Results:
- Analyzed 11 publications, totaling 54 patients.
- Common symptoms included diarrhea and weight loss; laboratory findings showed anemia and hypoalbuminemia.
- Duodenal villous atrophy was observed in 98% of patients, with negative celiac disease serology.
- All patients improved after discontinuing olmesartan.
Conclusions:
- Olmesartan-associated sprue-like enteropathy is a distinct clinical entity.
- It should be considered in differential diagnoses when celiac disease tests are negative.
- Prompt diagnosis and olmesartan withdrawal are crucial for patient recovery.
