Abstract
Olmesartan drug-induced enteropathy was first reported 10 years ago. Its physiopathology remains largely unknown and its evocation facing diarrhea is still not systematic, especially in cases of acute and severe diarrhea episodes. In this paper, we report the case of a 71-year-old woman presenting with acute diarrhea associated with complete duodenal mucosal villous atrophy with lymphocytic infiltration. Due to disease severity organ failure will occur and admission to intensive care unit is required for renal replacement therapy. After an exhaustive diagnostic procedure, the long-prescribed Olmesartan was incriminated and discontinued. The diagnosis of coeliac disease was excluded after a negative HLA DQ2-DQ8 genotyping. Clinical and pathological evolution at 3 months was favorable after stopping Olmesartan.
The aim of this case study is to highlight the acute presentation inducing a life-threatening condition of Olmesartan related enteropathy, which is rare and still little-known among general practitioners. We also discuss the pathophysiology of this disease, as applied to the clinical case presented.
Keywords
Olmesartan, Drug-induced enteropathy, Organ failure, Acute diarrhea, Case Report