# Olmesartan-Induced Enteropathy: When the Treatment of One Disease Causes Another

## TL;DR

Olmesartan, a blood pressure medication, can cause an intestinal condition resembling celiac disease, which resolves when the drug is stopped.

## Contribution

The paper highlights olmesartan-induced enteropathy as a rare but important diagnosis to consider in patients on long-term olmesartan therapy.

## Key findings

- The patient's symptoms resolved after discontinuing olmesartan and recurred upon resuming it.
- Duodenal biopsy showed features similar to celiac disease, but serology did not confirm it.
- The condition was diagnosed as a drug-induced enteropathy after ruling out other causes.

## Abstract

Olmesartan is an angiotensin II receptor antagonist used for the management of hypertension. This drug can lead to an enteropathy that clinically and histologically resembles coeliac disease. Symptoms may appear months or years after the introduction of the drug and usually resolve after discontinuation.

The authors present a case of an 86-year-old woman with hypertension who was treated with olmesartan for 10 years. She presented to the emergency department with diarrhoea after three months of development and weight loss. The aetiological study that was conducted excluded infectious, inflammatory, endocrinological, and neoplastic causes. The pathological anatomy of the duodenal biopsy was suggestive of coeliac disease, but the serology was not compatible. The patient presented complete remission of the condition with the suspension of the drug and subsequent recrudescence when, by self-initiation, she resumed olmesartan.

This case study aims to alert readers of a rare cause of enteropathy with a clinical manifestation that mimics coeliac disease. Olmesartan-induced enteropathy seems to be a diagnosis of exclusion and should be considered in patients chronically medicated with olmesartan.