70-year-old woman with chronic diarrhea

Systematic review: Clinical phenotypes, histopathological features and prognosis of enteropathy due to angiotensin II receptor blockers

“…p < 0.05 were considered statistically significant. Ninety-four were case reports or case series of enteropathy due to ARBs (86 case reports or case series with less than five patients and eight case series with five or more patients 5,11,[99][100][101][102][103][104] ) corresponding to a total of 183 patients (101 F, mean age at diagnosis 69 ± 10 years) published between 2012 and 2023, with most cases being reported in Europe (93 cases) 11,13,17,18,20,21,23,24,26,27,[30][31][32][33][34]40,44,45,50,51,[55][56][57][61][62][63][64]67,68,70,73,75,77,80,[83][84][85][89][90][91]…”

“…14,22,73,102,104 In addition to VA, data on intraepithelial lymphocytes (IEL) count was reported for 83 patients and was increased in 79/83 (95.2%). patients, 11,17,19,21,30,32,43,45,54,55,57,62,78,88,97,101 and in 20 patients the presence of a thickened sub-epithelial collagen band was repo rted. 11,17,24,25,30,47,48,57,58,62,65,66,69,72,78,94,102 Figure 3 shows the typical histopathological features in the duodenum of a patient affected by OAE at baseline and after ARBs suspension.…”

“…The final diagnosis was reached after a median of 5 months, and an acute onset of symptoms leading to diagnosis was present in 10% of patients. Coeliac serology results were reported in 140/183 5,11,13,14,[16][17][18][19][20][21][22]24,25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40]83,84,86,[89][90][91][92][94][95][96][97][98][99][100][101] and were negative in the large majority of cases (138/140, 99%). In only two patients, IgA tissue transglutaminase antibodies were borderline and considered to be irrelevant by the authors.…”

“…VA was present in 164/183 (89%) patients. 5,11,13,14,[16][17][18]20,21,24,25,[27][28][29][30][31][32][33][34][35][36][37][38][39][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][90][91][92][93][94][95][96][97][98][99][100][101][102][103]…”

“…As shown in Table 2, the endoscopic investigations performed in these 183 patients included upper GI endoscopy in 177, 5,11,[13][14][15][16][17][18][19][20][21] colonoscopy in 117 5,11,13,14,16,17,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][36][37][38][40][41][42][44][45][46][47][48][49][50][51][52]57,58,[60][61]…”