Olmesartan Associated Enteropathy as an Inflammatory Bowel Disease Mimicker in a Patient With Hidradenitis Suppurativa

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

“…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 5,11,13,14,16–22,24,25,27–40,43–80,83,84,86,89–92,94–101 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 19,37 .…”

“…Overall, we included 97 papers in the present review. Ninety‐four were case reports or case series of enteropathy due to ARBs (86 case reports or case series with less than five patients 13–98 and eight case series with five or more patients 5,11,99–104 ) 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) 11,13,17,18,20,21,23,24,26,27,30–34,40,44,45,50,51,55–57,61–64,67,68,70,73,75,77,80,83–85,89–92,94–96,98,100,101,103,104 and North America (67 cases) 5,14,16,22,25,28,29,36–38,41–43,46,47,52–54,58,60,66,69,71,72,86,93,97,102 . Some cases were also reported in India (9),…”

“…Data on faecal calprotectin were reported for only 24/183 patients, 11,23,24,29,32,37,44,45,47,49,73,78,79,86 and it was increased in 14/24 (58%) 11,23,24,29,44,45,47,49,86 . Data on which other medications were being taken besides ARBs was reported explicitly for 57 patients, 13,14,16,18,20,25,26,30–33,36–42,44,45,47,50,51,54,57,58,61–64,66–68,70–75,77–79,82,84,86,87,91–93,95,97,103 with 9/57 reporting no other medication 14,18,20,30,40,61,67,68,82 and the remaining 48/57 taking mainly diuretics, statins or a second anti‐hypertensive medication. NSAID use was reported for five cases 36,42,54,64,71 and PPI in other six cases 26,38,51,73,77,97 …”

“…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]…”

“…11 Whether a follow-up OGD was performed or not was reported for 144 patients (78.7%). 5,11,[13][14][15][16][17][18][19][20][21][23][24][25][26][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]47,48,51,54,56,[58][59][60][61][62][63][65][66][67][68][69][70]72,[...…”