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奥尔梅沙坦诱导的胃炎和肠病的非典型表现
H Schreurs1, C Breynaert1, G De Hertogh2
1Department of Internal medicine, University Hospitals Leuven, Leuven, Belgium.
Acta gastro-enterologica Belgica
|June 12, 2025
概括
奥尔梅沙坦药物可以导致严重的胃炎和肠病. 这一案例突显了药物诱导的肠道乳腺细胞增加,与全身性乳腺细胞瘤不同,在奥尔梅沙坦戒药后得到改善.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 奥尔梅沙坦是一种血管激素II受体阻断剂 (ARB),广泛用于高血压管理.
- 奥尔梅沙坦相关肠道病变 (OAE) 是一种已知的不良反应,其特征是状缩和炎症.
- 在药物诱导的胃肠道病理中,特定的炎症细胞 (如巨细胞) 的作用需要进一步阐明.
研究的目的:
- 报告与olmesartan使用相关的严重胃炎和肠病症的独特病例.
- 为了调查组织病理学发现,特别是乳腺巨细胞的存在,在olmesartan诱导的胃肠道损伤.
- 在与奥尔梅沙坦相关的胃肠道疾病的背景下,区分药物诱导的乳腺细胞变化与全身性乳腺细胞瘤症.
主要方法:
- 一个81岁的女性患者的病例报告显示,她患有厌食症和体重减轻.
- 临床评估包括药物史 (奥尔梅沙坦),症状评估和随访胃镜检查.
- 胃肠道活检的组织病理学分析,重点是炎症细胞透 (乙酸性细胞,淋巴细胞,巨细胞).
主要成果:
- 患者患有严重的胃炎和肠病,归因于olmesartan.
- 停用olmesartan导致显著的症状改善和内镜愈合.
- 组织病理学揭示了低氨基和内皮细胞淋巴细胞减少,但巨细胞持续增加,不包括全身巨细胞.
结论:
- 这一案例表明,奥尔梅沙坦可以诱导严重的胃炎和肠道病变,在胃粘膜中突出地存在巨细胞.
- 药物诱导的巨细胞透是olmesartan相关的胃肠道不良事件的潜在机制,模仿但与系统性巨细胞瘤不同.
- 需要进行进一步的研究,以探索局部巨细胞在奥尔梅沙坦诱导的胃肠病理和其他与药物相关的肠病变中的作用.
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