Annalisa Schiepatti1, Federico Biagi1, Davide Cumetti2, Ombretta Luinetti3, Aurelio Sonzogni4, Amedeo Mugellini5, Gino R Corazza1. 1. a First Department of Internal Medicine , Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy . 2. b Department of Internal Medicine , Azienda Ospedaliera Papa Giovanni XXIII , Bergamo , Italy . 3. c Department of Pathology , Fondazione IRCCS Policlinico San Matteo , Pavia , Italy . 4. d Department of Pathology , Azienda Ospedaliera Papa Giovanni XXIII , Bergamo , Italy , and. 5. e Second Department of Internal Medicine , Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy.
Abstract
INTRODUCTION: The association between olmesartan and an enteropathy histologically indistinguishable from untreated celiac disease has recently been described. However, pathogenetic mechanisms leading to villous atrophy, prevalence, natural history and genetic background of this condition have not yet been defined. PATIENTS: We describe here two cases of olmesartan-associated enteropathy and discuss some aspects of the natural history of this condition. RESULTS: In both patients, an infectious episode seems to have triggered the severe malabsorption syndrome which led them to hospitalization. High titer positive antinuclear antibodies with homogeneous pattern were found. CONCLUSIONS: Our reports add to a growing body of evidence suggesting that olmesartan-associated enteropathy should be considered in the presence of villous atrophy and negative celiac serology and in the diagnostic algorithm of non-responsive celiac disease.
INTRODUCTION: The association between olmesartan and an enteropathy histologically indistinguishable from untreated celiac disease has recently been described. However, pathogenetic mechanisms leading to villous atrophy, prevalence, natural history and genetic background of this condition have not yet been defined. PATIENTS: We describe here two cases of olmesartan-associated enteropathy and discuss some aspects of the natural history of this condition. RESULTS: In both patients, an infectious episode seems to have triggered the severe malabsorption syndrome which led them to hospitalization. High titer positive antinuclear antibodies with homogeneous pattern were found. CONCLUSIONS: Our reports add to a growing body of evidence suggesting that olmesartan-associated enteropathy should be considered in the presence of villous atrophy and negative celiac serology and in the diagnostic algorithm of non-responsive celiac disease.