Clinical-Pathological Conference Series from the Medical University of Graz

Fabian, Elisabeth; Schiller, Dietmar; Wenzl, H; Lackner, Carolin; Donnerer, Josef; Ziachehabi, A; Silye, René; Schöfl, R; Krejs, Guenter J.

doi:10.1007/s00508-015-0882-8

Cited by 7 publications

(16 citation statements)

References 43 publications

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“…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]…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Duodenal Histopathological Featuresmentioning

confidence: 98%

“…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.…”

Section: Baseline Clinical Featuresmentioning

confidence: 99%

“…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]…”

Section: Duodenal Histopathological Featuresmentioning

confidence: 99%

“…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]…”

Section: Distribution Of Mucosal Changes Throughout the Gi Tractmentioning

confidence: 99%

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

Schiepatti,

Minerba,

Puricelli

et al. 2024

Aliment Pharmacol Ther

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SummaryBackgroundAlthough enteropathy due to angiotensin II receptor blockers (ARBs) has been known for over 10 years, clinicians' awareness of this condition is still low.AimsTo systematically review the literature about clinical phenotypes, distribution of mucosal changes throughout the gastrointestinal tract and prognosis of enteropathy due to ARBs.MethodsAccording to PRISMA guidelines, we searched PubMed and Embase for relevant articles up to November 6, 2023. We included full‐text papers, letters, case reports and case series describing enteropathy due to ARBs. Patients were classified into subgroups based on endoscopic and histological findings of different regions of the gastrointestinal tract. The protocol was registered with Open Science Framework (https://doi.org/10.17605/OSF.IO/TK67C).ResultsWe included 94 articles reporting 183 cases (101 female, mean age at diagnosis 69 ± 10 years). The clinical picture at diagnosis was characterised by severe diarrhoea (97%) and weight loss (84%, median −13 kg), leading to hospital admission in 167 (95%) patients. Olmesartan (90%) was most frequently implicated. Villous atrophy (VA) was reported in 164/183 (89%) patients. One hundred and nine had only VA, 12 had pan‐gastrointestinal involvement, 23 had VA and gastric involvement and 19 had VA and colon involvement (predominantly microscopic colitis). Outcomes were reported for 178/183 (97%) patients, who all recovered clinically on ARBs withdrawal. Histological recovery occurred in all 96 patients with VA at baseline who underwent follow‐up duodenal biopsy.ConclusionsEnteropathy due to ARBs is characterised by severe malabsorption often requiring hospital admission and can involve the entire gastrointestinal tract. Clinician awareness can lead to prompt diagnosis and excellent prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Duodenal Histopathological Featuresmentioning

confidence: 98%

Section: Baseline Clinical Featuresmentioning

confidence: 99%

Section: Duodenal Histopathological Featuresmentioning

confidence: 99%

Section: Distribution Of Mucosal Changes Throughout the Gi Tractmentioning

confidence: 99%

See 3 more Smart Citations

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

Schiepatti,

Minerba,

Puricelli

et al. 2024

Aliment Pharmacol Ther

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Association of sprue-like enteropathy and angiotensin receptor-1 antagonists

Wenzel

Datz

2019

Wien Klin Wochenschr

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Clinical-Pathological Conference Series from the Medical University of Graz

Fabian

Tinchon

Lueger

et al. 2020

Wien Klin Wochenschr

Self Cite

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The patient came to Austria as a refugee during the Yugoslav Wars 25 years ago. She was in the 7th week of pregnancy when her husband brought her to the emergency room (ER) of the Graz University Medical Center at 3 o'clock in the morning due to increasing dyspnea. She also complained of a dry cough but there was no fever. She had had a miscarriage 7 months previously and 3 years earlier, the patient had had a cesarean section at 40 weeks of gestation due to fetal distress. A healthy infant was delivered, weighing 3290 g and measuring 52 cm in length. At that time the hemoglobin before the cesarean section was 11.0 g/dL (normal: 12.0-15.3 g/dL), the mean corpuscular volume (MCV) was 82.8 fL (normal: 80-98 fL) and hemoglobin after delivery was 9.2 g/dL. On the current admission, she did not complain of any pain

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Clinical-Pathological Conference Series from the Medical University of Graz

Cited by 7 publications

References 43 publications

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

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

Association of sprue-like enteropathy and angiotensin receptor-1 antagonists

Clinical-Pathological Conference Series from the Medical University of Graz

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