Volume 5, Issue 6, November 2019, Page: 72-74
Duodenal Villous Atrophy and Diarrhea Associated with Chronic Olmesartan Intake
Giulia Colombo, Department of General Medicine Hemostasis and Thrombosis, Foundation IRCCS Ca' Granda Hospital Policlinic Maggiore, Milan, Italy
Raffaella Rossio, Department of General Medicine Hemostasis and Thrombosis, Foundation IRCCS Ca' Granda Hospital Policlinic Maggiore, Milan, Italy
Barbara Ferrari, Department of General Medicine Hemostasis and Thrombosis, Foundation IRCCS Ca' Granda Hospital Policlinic Maggiore, Milan, Italy
Letterio Runza, Department of Pathological Anatomy, Foundation IRCCS Ca’ Granda Hospital Policlinic Maggiore, Milan, Italy
Peyvandi Flora, Department of General Medicine Hemostasis and Thrombosis, Foundation IRCCS Ca' Granda Hospital Policlinic Maggiore, Milan, Italy; Department of Pathophysiology and Transplantation, Foundation IRCCS Ca’ Granda Hospital Policlinic Maggiore, Milan, Italy; Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Foundation Luigi Villa, Milan, Italy
Received: Nov. 8, 2019;       Accepted: Nov. 29, 2019;       Published: Dec. 6, 2019
DOI: 10.11648/j.ijpc.20190506.12      View  519      Downloads  213
Abstract
Olmesartan is an angiotensin II receptor blocker (ARB) approved for the treatment of hypertension since 2002. Olmesartan-associated enteropathy (OAE), first described in 2012 by Rubio-Tapia, has seldom been considered as a diagnosis in patients with villous atrophy and negative serology for celiac disease. The clinical presentation could be extremely heterogenous. In contrast to celiac disease, there is no response to a gluten-free diet. The exact mechanism of intestinal injury still remains unknown. The histological pattern, at the upper gastrointestinal endoscopy, usually reveals a variable degree of villous atrophy and a moderate infiltration of lymphocytes at mucosal level. Symptoms usually improve upon olmesartan discontinuation and the repeat endoscopy could demonstrate complete resolution of inflammatory change with normal villous architecture. The differential diagnosis for this kind of clinical and pathological features include celiac disease, tropical sprue, autoimmune enteropathy, inflammatory bowel disease, and drug induced enteropathy. With this background, we report the case of a patient with a clinical picture compatible with seronegative celiac disease and symptoms that rapidly improved clinically and histologically after olmesartan discontinuation. In conclusion, although this condition is rare, physicians should be consider this medication in the differential diagnosis of this enteropathy.
Keywords
Olmesartan, Celiac Disease, Enteropathy, Diarrhea, Weight Loss, Nausea
To cite this article
Giulia Colombo, Raffaella Rossio, Barbara Ferrari, Letterio Runza, Peyvandi Flora, Duodenal Villous Atrophy and Diarrhea Associated with Chronic Olmesartan Intake, International Journal of Pharmacy and Chemistry. Vol. 5, No. 6, 2019, pp. 72-74. doi: 10.11648/j.ijpc.20190506.12
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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