Abstract
Olmesartan-induced enteropathy mimics celiac disease clinically and pathologically. As in celiac disease, the pathologic findings are villous atrophy and increased intraepithelial lymphocytes. Clinical presentation of olmesartan-induced enteropathy includes diarrhea, weight loss, and nausea. In contrast to celiac disease, tissue transglutaminase is not elevated and there is no response to a gluten-free diet. Including this entity in the differential diagnosis of sprue-like enteropathy is critical for its early diagnosis since replacing olmesartan with an alternative antihypertensive drug can simplify the diagnostic workup and provide both clinical and histologic improvement.
Keywords:
celiac disease; diarrhea; olmesartan-induced enteropathy.
MeSH terms
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Aged
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Angiotensin II Type 1 Receptor Blockers / adverse effects*
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Antihypertensive Agents / adverse effects*
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Atrophy
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Biopsy
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Celiac Disease / diagnosis
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Diagnosis, Differential
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Diarrhea / chemically induced
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Drug Substitution
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Female
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Humans
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Hypertension / drug therapy*
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Imidazoles / adverse effects*
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Intestinal Diseases / chemically induced*
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Intestinal Diseases / diagnosis
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Intestinal Diseases / immunology
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Intestinal Mucosa / drug effects*
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Intestinal Mucosa / immunology
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Intestinal Mucosa / pathology
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Lymphocytes / drug effects
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Lymphocytes / immunology
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Microvilli / drug effects
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Microvilli / pathology
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Predictive Value of Tests
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Tetrazoles / adverse effects*
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Weight Loss / drug effects
Substances
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Angiotensin II Type 1 Receptor Blockers
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Antihypertensive Agents
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Imidazoles
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Tetrazoles
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olmesartan