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

Olmesartan-Associated Enteropathy

“…All were on olmesartan, and upon discontinuing this agent, their symptoms resolved or signifi cantly improved with histologic recovery. Other reports of olmesartan-associated enteropathy have since appeared in the gastroenterology literature (2)(3)(4). Patients typically present with severe chronic diarrhea accompanied by abdominal bloating and cramping, usually with weight loss, nausea, and vomiting, and frequently require hospitalization for intravenous hydration.…”

Olmesartan - associated sprue-like enteropathy and colagenous colitis: A case report and review of literature

“…[3,4,12,13] OAE affects men and women equally, with most affected patients between the age of 46-91 years (mean age, 68 years). [1][2][3][4][5][6][7] The average dose of olmesartan in affected patients is 40 mg per day. Chronic diarrhea with weight loss is the most common clinical presentation.…”

“…Recent reports have suggested an association between use of olmesartan and a sprue-like enteropathy, with affected patients presenting with severe, protracted diarrhea and weight loss that improves after discontinuation of olmesartan. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Although the symptoms and histologic findings of olmesartan-associated enteropathy (OAE) resemble severe celiac disease, negative laboratory testing for celiac disease and lack of a response to a gluten-free diet suggest that OAE is a separate clinical entity. The pathogenesis of this entity remains to be elucidated.…”

Not All That Flattens Villi Is Celiac Disease: A Review of Enteropathies

“…10 It is typically classified by severe malabsorptive symptoms commonly leading to nutritional deficiencies and electrolyte abnormalities. 11 Most cases have either human leukocyte antigen DQ2 or DQ8 haplotype. Histologic features, including villous atrophy and a subepithelial collagenous layer consistent with collagenous sprue, can be found in the small bowel, gastric, and colonic mucosa.…”

“…Histologic features, including villous atrophy and a subepithelial collagenous layer consistent with collagenous sprue, can be found in the small bowel, gastric, and colonic mucosa. 11 Diagnosis requires these histologic findings, negative celiac serology, lack of response to a gluten-free diet, and improvement after discontinuing olmesartan. 10 Treatment involves withdrawal of the drug, and in severe cases topical or systemic corticosteroids.…”