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sprue-like enteropathy

G Solano-Iturri, N García-Jiménez, J D Solano-Iturri, S Blanco-Sampascual
No abstract text is available yet for this article.
March 10, 2017: Revista de Gastroenterología de México
Abimbola Adike, Juan Corral, David Rybnicek, Daniel Sussman, Samir Shah, Eamonn Quigley
Olmesartan-induced enteropathy mimics celiac disease clinically and pathologically. As in celiac disease, the pathologic findings are villous atrophy and increased intraepithelial lymphocytes. Clinical presentation of olmesartan-induced enteropathy includes diarrhea, weight loss, and nausea. In contrast to celiac disease, tissue transglutaminase is not elevated and there is no response to a gluten-free diet. Including this entity in the differential diagnosis of sprue-like enteropathy is critical for its early diagnosis since replacing olmesartan with an alternative antihypertensive drug can simplify the diagnostic workup and provide both clinical and histologic improvement...
October 2016: Methodist DeBakey Cardiovascular Journal
Badr Al-Bawardy, Shannon P Sheedy, Michelle B Herberts, Joseph A Murray, Alberto Rubio-Tapia, Elizabeth Rajan, David H Bruining, Stephanie L Hansel, John M Barlow, Joel G Fletcher, Jeff L Fidler
PURPOSE: Collagenous sprue (CS) is a rare enteropathy characterized by villous atrophy and a thickened subepithelial collagen band. The aim of this study is to describe the cross-sectional imaging findings of CS. METHODS: A case-control, retrospective study with cases of all CS patients from January 2000 to 2015 was performed. Inclusion criteria were (1) Histopathologic diagnosis and (2) Imaging with computed tomography abdomen/pelvis (CT A/P), CT enterography (CTE), or magnetic resonance enterography within 6 months of small bowel (SB) biopsy...
January 5, 2017: Abdominal Radiology
Michail Galanopoulos, Lazaros Varytimiadis, Athanasios Tsigaridas, Pantelis S Karatzas, Emmanuel Archavlis, Nikos Viazis, Christina Vourlakou, Gerassimos J Mantzaris
Sprue-like enteropathy associated with treatment with olmesartan medoxomil, an angiotensin II receptor blocker, has been described recently. Herein, we report two patients who developed chronic severe non-bloody diarrhea, weight loss, and muscle wasting after prolonged use of olmesartan. Histologic and immunohistochemical examination of multiple duodenal biopsies revealed severe villous atrophy. Clinical signs ceased upon drug discontinuation. Physicians should be aware of this enteropathy even if olmesartan has been taken for months or years...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Isidro Machado, María Reolid, Fernando Martínez de Juan, Carmen Martínez Lapiedra, Fernanda Maia de Alcántara
We describe a new case of enteropathy with villous atrophy in a patient suffering from arterial hypertension treated with olmesartan. The molecular and serological studies showed anti-nuclear antibodies (ANA) and haplotype HLA-DQ2 positive, as well as negative results for anti-transglutaminase, anti-endomysium and anti-enterocytes antibodies. A duodenal villous atrophy was suspected by upper gastrointestinal endoscopy, which was confirmed by histopathology. The morphological picture was suggestive of sprue-like enteropathy with severe lymphoid infiltration and predominant T lymphoid cells...
November 2016: Revista Española de Enfermedades Digestivas
Pedro Luis González-Cordero, Nuria Fernandez-Gonzalez, Javier Molina-Infante
No abstract text is available yet for this article.
November 2016: American Journal of Gastroenterology
Cláudio Martins, Cristina Teixeira, Suzane Ribeiro, Daniel Trabulo, Cláudia Cardoso, João Mangualde, Ricardo Freire, Ana Luísa Alves, Élia Gamito, Isabelle Cremers, Ana Paula Oliveira
Celiac disease is the most important cause of intestinal villous atrophy. Seronegative intestinal villous atrophy, including those that are nonresponsive to a gluten-free diet, is a diagnostic challenge. In these cases, before establishing the diagnosis of seronegative celiac disease, alternative etiologies of atrophic enteropathy should be considered. Recently, a new clinical entity responsible for seronegative villous atrophy was described-olmesartan-induced sprue-like enteropathy. Herein, we report two uncommon cases of atrophic enteropathy in patients with arterial hypertension under olmesartan, who presented with severe chronic diarrhea and significant involuntary weight loss...
2016: Case Reports in Gastrointestinal Medicine
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MED WATCH program (800-FDA-1088). If you have reported an interesting, preventable ADR to MED WATCH, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: Your report will be published anonymously unless otherwise requested...
November 2015: Hospital Pharmacy
Tasha Kulai, Thomas Arnason, Donald MacIntosh, John Igoe
Olmesartan, an angiotensin II receptor antagonist used to treat hypertension, is associated with few adverse effects. Here, a case of severe sprue-like enteropathy and acute kidney injury is described in a 68-year-old male taking olmesartan for 3-4 years. He presented to hospital with a five-week history of diarrhea, vomiting, and a 20 lb weight loss. Anti-TTG was negative with a normal IgA. Biopsies of the distal duodenum and duodenal cap revealed marked blunting of the villi with near complete villous atrophy of the biopsies from the bulb...
2016: Canadian Journal of Gastroenterology & Hepatology
Claudine Desruisseaux, Michaël Bensoussan, Etienne Désilets, Hanh-Khiem Tran, Robert Arcand, Germain Poirier, Andrew Wisniewski, Thibaut Manière
Collagenous sprue (CS) is a distinct clinicopathological disorder histologically defined by a thickened subepithelial band (Freeman, 2011). It is a rare condition which has been recently observed in a significant proportion of sprue-like enteropathy associated with olmesartan, a novel entity described by Rubio-Tapia et al. in 2012. CS is historically associated with a poor prognosis (Marthey et al., 2014). However, histological and clinical improvements have been described in most studies with concomitant usage of corticosteroids and/or gluten-free diet (Marthey et al...
2016: Canadian Journal of Gastroenterology & Hepatology
(no author information available yet)
A cohort study conducted in 2014, using data from France's mandatory health insurance system, has shown a 10-fold increased risk of hospitalisation for enteropathy with olmesartan in comparison with other ARBs (sartans) or ACE inhibitors. The increased incidence of enteropathy with olmesartan compared with other ARBs or ACE inhibitors is well documented. The French drug regulatory agency, ANSM, informed healthcare professionals of these risks in 2014. Yet prescription rates for olmesartan remain high, and new cases of olmesartan-associated enteropathy continue to be reported...
May 2016: Prescrire International
Esteban Sáez González, Francia Carolina Díaz Jaime, Adolfo Del Val Antoñana
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...
October 2016: Revista Española de Enfermedades Digestivas
Nassim Hammoudi, Marie Dior, Vincent Giraud, Benoit Coffin
Olmesartan is an angiotensin II receptor antagonist which may cause severe sprue-like enteropathy with duodenal villous atrophy. Skin lesions may be associated as reported for the first time in our case. Clinicians should be informed of this side effect and its reversibility after suspension of the drug.
April 2016: Clinical Case Reports
Gianluca Ianiro, Antonio Gasbarrini, Giovanni Cammarota
No abstract text is available yet for this article.
July 2016: Scandinavian Journal of Gastroenterology
Nina Burbure, Benjamin Lebwohl, Carolina Arguelles-Grande, Peter H R Green, Govind Bhagat, Stephen Lagana
Sprue-like enteropathy associated with the angiotensin II receptor blocker (ARB) olmesartan was first described in 2012, and a number of cases have since been reported. This syndrome is characterized by severe diarrhea and sprue-like histopathologic findings in the intestine, often with increased subepithelial collagen. The incidence of this adverse drug reaction is not entirely clear, although it is thought to be rare. It is also not well established if other ARBs cause such a syndrome, although case reports suggest they can...
April 2016: Human Pathology
Amaia Campos Ruiz, Leire Urtasun Arlegui, Carlos Marra-López Valenciano
Olmesartan is a therapy used for the management of hypertension available since 2002. A sprue like enteropathy associated with olmesartan has been first described in 2012. Endoscopic and histopathological findings are partial or total villous atrophy, mimicking a Celiac Disease. We explain two cases diagnosed in our hospital. Both patients took more than one year of treatment with olmesartan. In both cases, the biopsy showed duodenal villous atrophy, negative serology for celiac disease and they improved after stopping treatment with olmesartan...
May 2016: Revista Española de Enfermedades Digestivas
N Imperatore, R Tortora, P Capone, N Caporaso, A Rispo
No abstract text is available yet for this article.
March 2016: Scandinavian Journal of Gastroenterology
Cándido Muñoz-Muñoz, Josefa López-Vivancos, Walter Huaman, Montserrat García-Cors
A case of spue-like enteropathy due to olmesartan is reported to draw attention to this disease, given the high frequency of use of this drug and the difficulty of diagnosis if the entity if it is not known. In his journal one case was published as Clinical Note in 2014 and we wish to emphasize the importance of knowledge about this relatively new entity.
October 2015: Revista Española de Enfermedades Digestivas
E V Marietta, A M Nadeau, A K Cartee, I Singh, A Rishi, R S Choung, T-T Wu, A Rubio-Tapia, J A Murray
BACKGROUND: Olmesartan-associated enteropathy (OAE) is characterised by diarrhoea, nausea, vomiting, abdominal pain, weight loss and severe sprue-like enteropathy, all of which are resolved after discontinuation of olmesartan medoximil. AIM: To determine the mechanistic similarities of OAE with coeliac sprue. METHODS: Duodenal biopsies were extracted from OAE patients before (n = 11) or after (n = 17) discontinuation of olmesartan medoxomil (on or off olmesartan medoxomil)...
December 2015: Alimentary Pharmacology & Therapeutics
Dhaval K Naik, Matthew G Martelli, David Hernandez Gonzalo, Anil K Sharma, Davinderbir Pannu
Olmesartan use has been associated with chronic diarrhoea and weight loss due to severe sprue-like enteropathy, yet this is still not well known among clinicians. We present the unique case of an 84-year-old Filipino woman diagnosed with olmesartan-induced sprue-like enteropathy after an extensive work up for chronic diarrhoea, and without improvement despite multiple empiric treatments for nearly 15 months. Withdrawal of olmesartan resulted in clinical and histological improvement. This case provides further evidence for olmesartan-induced sprue-like enteropathy, and emphasises the importance of its awareness and recognition among gastroenterologists and primary care physicians alike...
2015: BMJ Case Reports
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