Korean J Gastroenterol.  2022 Mar;79(3):130-134. 10.4166/kjg.2022.007.

Olmesartan-associated Enteropathy with Acute Kidney Injury

Affiliations
  • 1Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Korea
  • 2Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea

Abstract

Olmesartan, a recently introduced angiotensin II receptor blocker for hypertension, has been reported to cause drug-induced small bowel enteropathy. The diagnosis of olmesartan-associated enteropathy (OAE) needs clinical suspicion and the exclusion of coeliac disease, as it mimics coeliac sprue. Once diagnosed, it can be completely cured with the discontinuation of olmesartan. However, due to the extremely low incidence of OAE in Korea, clinical suspicion and diagnosis may be a challenge. The authors report the first case of OAE presenting with chronic diarrhea and acute kidney injury in Korea.

Keyword

Olmesartan; Enteropathy; Diarrhea; Acute kidney injury

Figure

  • Fig. 1 Endoscopic retrograde choangiopancreatography (ERCP) at the time of initial diagnosis. ERCP reveals (A) major papilla and (B) minor papilla.

  • Fig. 2 Pathologic findings of the duodenum. (A) Loss of villi structures and erosion (hematoxylin and eosin [H&E], ×100) and (B) chronic active inflammation of gland structures (H&E, ×200).

  • Fig. 3 Hospital course of the patient’s stool amount and the number of diarrhea episodes per day.

  • Fig. 4 Images of video capsule endoscopy showing recovered villi and the disappearance of edema on the (A) distal duodenum and (B) upper jejunum.


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