Olmesartan-associated enteropathy: new insights on the natural history? Report of two cases.
BACKGROUND
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.


METHODS
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.
a First Department of Internal Medicine , Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy .
Annalisa
A
Schiepatti
a First Department of Internal Medicine , Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy .
Federico
F
Biagi
b Department of Internal Medicine , Azienda Ospedaliera Papa Giovanni XXIII , Bergamo , Italy .
Davide
D
Cumetti
c Department of Pathology , Fondazione IRCCS Policlinico San Matteo , Pavia , Italy .
Ombretta
O
Luinetti
d Department of Pathology , Azienda Ospedaliera Papa Giovanni XXIII , Bergamo , Italy , and.
Aurelio
A
Sonzogni
e Second Department of Internal Medicine , Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy.
Amedeo
A
Mugellini
a First Department of Internal Medicine , Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy .
Gino R
GR
Corazza
D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects*; D001284:Atrophy / Q000139:chemically induced; D004378:Duodenal Diseases / Q000139:chemically induced* / Q000473:pathology*; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013777:Tetrazoles / Q000009:adverse effects*
D000959:Antihypertensive Agents; D007093:Imidazoles; D013777:Tetrazoles; C437965:olmesartan
celiac disease; enteropathy; olmesartan; villous atrophy