Severe spruelike enteropathy and collagenous colitis caused by olmesartan
Abstract Background Olmesartan, which is an angiotensin II receptor blocker, reportedly causes spruelike enteropathy, with intestinal villous atrophy as its typical histopathological finding. Interestingly, collagenous and/or lymphocytic gastritis and colitis occur in some patients. We report the ca...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-021-01926-y |
| _version_ | 1818885788664856576 |
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| author | Shiho Kaneko Kana Matsuda Yasuko Mizuta Shoya Shiratori Kazuma Kishi Akihisa Nakamura Masataka Yagisawa Nobuyuki Ehira Minoru Uebayashi Hiroya Kobayashi |
| author_facet | Shiho Kaneko Kana Matsuda Yasuko Mizuta Shoya Shiratori Kazuma Kishi Akihisa Nakamura Masataka Yagisawa Nobuyuki Ehira Minoru Uebayashi Hiroya Kobayashi |
| author_sort | Shiho Kaneko |
| collection | DOAJ |
| description | Abstract Background Olmesartan, which is an angiotensin II receptor blocker, reportedly causes spruelike enteropathy, with intestinal villous atrophy as its typical histopathological finding. Interestingly, collagenous and/or lymphocytic gastritis and colitis occur in some patients. We report the case of a 73-year-old Japanese man with a 2-month clinical history of severe diarrhea and weight loss. There were few reports in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. Case presentation We report a case of a 73-year-old man with a 2-month clinical history of severe diarrhea and weight loss. He had taken olmesartan for hypertension treatment for 5 years. Endoscopic examination with biopsies revealed intestinal villous atrophy and collagenous colitis. Suspecting enteropathy caused by olmesartan, which was discontinued on admission because of hypotension, we continued to stop the drug. Within 3 weeks after olmesartan discontinuation, his clinical symptoms improved. After 3 months, follow-up endoscopy showed improvement of villous atrophy but not of the thickened collagen band of the colon. However, the mucosa normalized after 6 months, histologically confirming that the preexistent pathology was finally resolved. Conclusions This report presents a case in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. In unexplained cases of diarrhea, medication history should be reconfirmed and this disease should be considered a differential diagnosis. |
| first_indexed | 2024-12-19T16:11:01Z |
| format | Article |
| id | doaj.art-39584405db714a4f8cd357966d1817ce |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-19T16:11:01Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-39584405db714a4f8cd357966d1817ce2022-12-21T20:14:45ZengBMCBMC Gastroenterology1471-230X2021-09-012111610.1186/s12876-021-01926-ySevere spruelike enteropathy and collagenous colitis caused by olmesartanShiho Kaneko0Kana Matsuda1Yasuko Mizuta2Shoya Shiratori3Kazuma Kishi4Akihisa Nakamura5Masataka Yagisawa6Nobuyuki Ehira7Minoru Uebayashi8Hiroya Kobayashi9Depertment of Gastroenterology, Kitami Red Cross HospitalDepertment of Gastroenterology, Kitami Red Cross HospitalDepertment of Gastroenterology, Kitami Red Cross HospitalDepertment of Gastroenterology, Kitami Red Cross HospitalDepertment of Gastroenterology, Kitami Red Cross HospitalDepertment of Gastroenterology, Kitami Red Cross HospitalDepertment of Gastroenterology, Kitami Red Cross HospitalDepertment of Gastroenterology, Kitami Red Cross HospitalDepertment of Gastroenterology, Kitami Red Cross HospitalDepartment of Pathology, Asahikawa Medical UniversityAbstract Background Olmesartan, which is an angiotensin II receptor blocker, reportedly causes spruelike enteropathy, with intestinal villous atrophy as its typical histopathological finding. Interestingly, collagenous and/or lymphocytic gastritis and colitis occur in some patients. We report the case of a 73-year-old Japanese man with a 2-month clinical history of severe diarrhea and weight loss. There were few reports in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. Case presentation We report a case of a 73-year-old man with a 2-month clinical history of severe diarrhea and weight loss. He had taken olmesartan for hypertension treatment for 5 years. Endoscopic examination with biopsies revealed intestinal villous atrophy and collagenous colitis. Suspecting enteropathy caused by olmesartan, which was discontinued on admission because of hypotension, we continued to stop the drug. Within 3 weeks after olmesartan discontinuation, his clinical symptoms improved. After 3 months, follow-up endoscopy showed improvement of villous atrophy but not of the thickened collagen band of the colon. However, the mucosa normalized after 6 months, histologically confirming that the preexistent pathology was finally resolved. Conclusions This report presents a case in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. In unexplained cases of diarrhea, medication history should be reconfirmed and this disease should be considered a differential diagnosis.https://doi.org/10.1186/s12876-021-01926-yVillous atrophyCollagenous colitisSpruelike enteropathyIntestinal diseasesCase report |
| spellingShingle | Shiho Kaneko Kana Matsuda Yasuko Mizuta Shoya Shiratori Kazuma Kishi Akihisa Nakamura Masataka Yagisawa Nobuyuki Ehira Minoru Uebayashi Hiroya Kobayashi Severe spruelike enteropathy and collagenous colitis caused by olmesartan BMC Gastroenterology Villous atrophy Collagenous colitis Spruelike enteropathy Intestinal diseases Case report |
| title | Severe spruelike enteropathy and collagenous colitis caused by olmesartan |
| title_full | Severe spruelike enteropathy and collagenous colitis caused by olmesartan |
| title_fullStr | Severe spruelike enteropathy and collagenous colitis caused by olmesartan |
| title_full_unstemmed | Severe spruelike enteropathy and collagenous colitis caused by olmesartan |
| title_short | Severe spruelike enteropathy and collagenous colitis caused by olmesartan |
| title_sort | severe spruelike enteropathy and collagenous colitis caused by olmesartan |
| topic | Villous atrophy Collagenous colitis Spruelike enteropathy Intestinal diseases Case report |
| url | https://doi.org/10.1186/s12876-021-01926-y |
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