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Olmesartan-Induced Sprue Like Enteropathy.

Liliana Carneiro1, Albina Moreira1, Adelina Pereira1

  • 1Medicine Department, Hospital Pedro Hispano, Matosinhos, Portugal.

GE Portuguese Journal of Gastroenterology
|September 5, 2017
PubMed
Summary

Olmesartan medication can cause sprue-like enteropathy, leading to chronic diarrhea and villous atrophy. Discontinuing the drug resolves these symptoms, highlighting its importance in differential diagnosis for unexplained gastrointestinal issues.

Keywords:
Atrophy/chemically inducedDiarrhoea/chemically inducedIntestinal MucosaOlmesartan

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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Pathology

Background:

  • Chronic diarrhea is a frequent and diagnostically challenging issue in gastroenterology.
  • Villous atrophy is a non-specific finding, necessitating consideration of drug-induced enteritis.
  • Olmesartan, an antihypertensive drug, has emerged as a potential cause of drug-induced enteropathy.

Observation:

  • Two cases of sprue-like enteropathy are presented in patients treated with olmesartan for arterial hypertension.
  • Patients experienced severe diarrhea and significant weight loss.
  • Histological examination revealed intestinal villous atrophy, mimicking celiac disease.

Findings:

  • Olmesartan-induced enteropathy is characterized by chronic diarrhea and duodenal mucosa atrophy.
  • Symptoms and histological findings resolved completely upon olmesartan withdrawal.
  • This condition should be considered in the differential diagnosis of villous atrophy when celiac serology is negative.

Implications:

  • Olmesartan-induced enteropathy is a newly recognized clinical entity.
  • Early recognition and drug discontinuation can prevent extensive investigations and improve patient quality of life.
  • This finding underscores the importance of a thorough medication history in diagnosing unexplained gastrointestinal symptoms.