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Telmisartan-induced sprue-like enteropathy: a case report.

Natalia Alzueta1, Amaya Echeverría1, Lorea Sanz1

  • 1Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain.

European Journal of Hospital Pharmacy : Science and Practice
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PubMed
Summary

Telmisartan, an angiotensin-receptor blocker for hypertension, may cause sprue-like enteropathy (SLE). Discontinuing telmisartan resolved symptoms in a patient, suggesting a causal link for this gastrointestinal condition.

Keywords:
adverse eventangiotensin-receptor Ii blockerdiarrheasprue-like enteropathytelmisartan

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Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Telmisartan is a widely used angiotensin-receptor II blocker (type 1) for managing hypertension.
  • Sprue-like enteropathy (SLE) has been previously associated with other drugs in the same class, such as olmesartan.

Observation:

  • An 80-year-old woman presented with diarrhea and abdominal pain after five years of daily telmisartan use for hypertension.
  • Gastrointestinal symptoms resolved completely after the discontinuation of telmisartan therapy.

Findings:

  • Causality assessment algorithms indicated a possible to likely causal relationship between telmisartan use and the development of SLE.
  • The patient remained asymptomatic after stopping the medication, supporting the identified association.

Implications:

  • Physicians should consider telmisartan as a potential cause of sprue-like enteropathy when evaluating patients with unexplained gastrointestinal symptoms.
  • Awareness of this association is crucial for accurate diagnosis and appropriate drug therapy review in hypertensive patients.