Severe Hepatitis Complicating Olmesartan Enteropathy: A Case Report

Area of Science:

• Gastroenterology
• Hepatology
• Internal Medicine

Background:

• Olmesartan, an angiotensin II receptor antagonist, is known to cause enteropathy.
• Olmesartan-induced enteropathy typically presents as a malabsorptive process, months to years after therapy initiation.
• Hepatic involvement is an uncommon but potential complication of olmesartan enteropathy.

Observation:

• A 43-year-old female presented with severe diarrhea and acute liver injury.
• The patient was on olmesartan therapy, and her symptoms were attributed to olmesartan enteropathy.
• The liver injury was characterized as acute, severe, ischemic, and enteropathic.

Findings:

• Cessation of olmesartan therapy led to rapid resolution of diarrheal symptoms.
• Liver function tests normalized within three weeks of discontinuing olmesartan.
• This case highlights a rare presentation of olmesartan enteropathy with significant hepatic involvement.

Implications:

• Clinicians should consider olmesartan enteropathy in patients with unexplained enteropathy and acute liver injury.
• High index of suspicion is crucial for timely diagnosis and management.
• Prompt discontinuation of olmesartan is key to reversing the adverse effects.