Year 2016 / Volume 108 / Number 10
Letter to the Editor
Clinical, laboratory, serological, and histological profile of sprue-like enteropathy associated with olmesartan use

685-686

DOI: 10.17235/reed.2016.4340/2016

Esteban Sáez González, Francia Carolina Díaz Jaime, Adolfo del Val Antoñana,

Abstract
Olmesartan is one of the various angiotensin II antagonists currently used for the management of high blood pressure. A sprue-like enteropathy was first described in 2012 in association with this antihypertensive drug. An observational, descriptive study was carried out on a series of 12 patients who met the clinical, histopathological, and outcome criteria for olmesartan-related sprue-like enteropathy from May 2013 to December 2015. All patients had watery diarrhea, weight loss, and negative celiac serology. They all were admitted with severe illness including dehydration with prerenal kidney failure, metabolic acidosis, water-electrolyte imbalance, and malnutrition parameters. Most common laboratory abnormalities included anemia and hypoalbuminemia. Duodenal biopsy histology revealed villous atrophy in all 12 patients. They all responded well to drug discontinuation, and 100% of individuals with follow-up biopsy showed histological recovery. Olmesartan should therefore be considered a potential cause of severe diarrhea, particularly in patients with duodenal villous atrophy and negative celiac serology.
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References
1. Rubio-Tapia A, Herman ML, Ludvigsson JF, et al. Severe sprue-like enteropathy associated with Olmesartan. Mayo Clin Proc 2012; 87:732-38
2. Laniro G, Bibbò S, Montalto M, et al. Systematic review: sprue-like enteropathy associated with olmesartan. Aliment Pharmacol Ther 2014; 40: 16–23
3. Marthey L, Cadiot G, Seksik P, et al. Olmesartan-associated enteropathy: results of a national survey. Aliment Pharmacol Ther 2014; 40: 1103 – 09.
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Sáez González E, Díaz Jaime F, del Val Antoñana A. Clinical, laboratory, serological, and histological profile of sprue-like enteropathy associated with olmesartan use . 4340/2016


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Publication history

Received: 22/03/2016

Accepted: 29/03/2016

Online First: 25/04/2016

Published: 30/09/2016

Article Online First time: 34 days

Article editing time: 192 days


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