title: [A new spruelike disease as a cause of severe diarrhea].
abstract: History and presentation at admission: A 77-years old woman presented with an 8-week history of pronounced diarrhea and weight loss of 10 kg.
  
  
  METHODS
  Infectious enteritis and chronic inflammatory bowel disease were excluded. Duodenal biopsies showed villous atrophy and 50 intraepithelial lymphocytes per 100 enterocytes, but antibody testing for celiac disease was negative.
  
  
  METHODS
  The diarrhea resolved within 2 weeks after withdrawing olmesartan, which she had received for hypertension for 5 years, without a gluten-free diet. 6 months later the histological abnormalities in the duodenum regressed markedly. A diagnosis of sprue-like enteropathy associated with olmesartan was made.
  
  
  CONCLUSIONS
  The syndrome is probably rare and was first described in 2012. It should be suspected in patients on olmesartan treatment who have clinical and histological findings, but not serological markers of celiac disease.
authors.affiliation: Klinik für Allgemeine Innere Medizin, Gastroenterologie, Hepatologie und internistische Onkologie, Klinikum Stuttgart.
authors.forename: D
authors.initials: D
authors.lastname: Halevy
authors.affiliation: Klinik für Endokrinologie, Diabetologie und Geriatrie, Klinikum Stuttgart.
authors.forename: U
authors.initials: U
authors.lastname: Teeuwen
authors.affiliation: Institut für Pathologie, Klinikum Stuttgart.
authors.forename: P
authors.initials: P
authors.lastname: Kohlhof
mesh_terms: D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D002446:Celiac Disease / Q000139:chemically induced* / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D002908:Chronic Disease; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D018565:Food-Drug Interactions; D006801:Humans; D007082:Ileum / Q000187:drug effects / Q000473:pathology; D007093:Imidazoles / Q000009:adverse effects* / Q000627:therapeutic use; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology; D013777:Tetrazoles / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D007093:Imidazoles; D013777:Tetrazoles; C437965:olmesartan