Potential coeliac disease markers and autoimmunity in olmesartan induced enteropathy: A population-based study

Impaired Barrier Function and Autoantibody Generation in Malnutrition Enteropathy in Zambia

“…We postulate that in the presence of mucosal T cell activation ( Campbell et al, 2003 , Veitch et al, 2001 ) and epithelial leakiness the cells of the lamina propria can generate autoantibodies, and that this autoreactivity exacerbates mucosal pathology. Autoantibody generation has been reported in Crohn's disease ( Ribeiro-Cabral et al, 2011 ) and in olmesartan-induced enteropathy ( Esteve et al, 2016 ) where it was reversible. Exposure to gluten and gliadin peptides is thought to be essential for development of the autoantibodies which characterize coeliac disease ( Sollid and Jabri, 2013 ), but in Zambia the staple diet is maize, and children being treated for SAM have a therapeutic feed which includes no gluten ( Ashworth et al, 2003 ).…”

Case of olmesartan-associated enteropathy and transient positive antitissue transglutaminase serology

“…Of the reported cases, only three tested positive for ATTG. Interestingly one patient had ATTG deposits on duodenal biopsy 6–9…”

Sprue-Like Enteropathy Associated With Olmesartan: A New Kid on the Enteropathy Block

“…The association with autoimmune diseases has been reported in several other studies. 3 , 5 , 23 In line with this observation, there are reports of individuals with sprue-like enteropathy associated with olmesartan responding to immunosuppressive treatment. 5 , 23 Our open-label experience suggests that some patients with severe symptoms, recurrent hospitalizations due to dehydration or both slow and/or partial response to olmesartan withdrawal may have some benefit from a short course of steroids such as budesonide ( Fig.…”

“… 2 The annual incidence rate of enteropathy in a French population-based study among patients treated with olmesartan for at least 6 months was calculated at 1.3 cases per 1000 individuals per year (95% confidence interval (CI) of 0.5–2.6). 3 This rate is not significantly different from the rate of 0.63 cases of incident celiac disease per 1000 reported by the Mini-Sentinel (95% CI: .38–.99) ( p = 0.16). 4 The Mini-Sentinel reported that rates of incident celiac disease were of similar magnitude for all angiotensin receptor blockers with, for instance, a rate of 0.43 cases per 1000 (95% CI: 0.33–0.55) for losartan.…”