Olmesartan-induced enteropathy – a little-known cause of chronic diarrhea
Keywords:
Olmesartan, diarrhoea, sprue-like enteropathy, villous atrophy, differential diagnosisAbstract
Olmesartan is an angiotensin II receptor antagonist used for management of hypertension since 2002. Since its marketing, mild side effects have been reported, in the forefront of which were headache and dizziness, and gastrointestinal symptoms are considered exceptional. However, more recently, severe digestive manifestations associated with its use have been described, with malabsorption syndrome secondary to villous atrophy, whose appearance is very similar to celiac disease (CD). Thus, a new condition was characterized, olmesartan-induced enteropathy (OIE), which manifests itself through diarrhea, weight loss and nausea. Despite the clinical and pathological correspondence with celiac sprue, drug-induced enteritis differs from this in that it does not present an elevation of transaminases, positivity of autoantibodies or response to a gluten-free diet, as we will illustrate with the following case.References
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