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September 2012, Volume 42 Number 9 , p 22 - 22



Twenty-two patients taking olmesartan were evaluated at the Mayo Clinic (Rochester, Minn.) for unexplained chronic diarrhea, weight loss, and enteropathy. Olmesartan is an angiotensin II receptor antagonist commonly prescribed for hypertension. Most of the patients were taking 40 mg/day (dosage range, 10 to 40 mg/day).Celiac disease was ruled out for all 22 patients because none of them had responded to a gluten-free diet. As revealed by intestinal biopsies, 15 patients had villous atrophy and mucosal inflammation and 7 had subepithelial collagen deposits (collagenous sprue). Researchers also documented seven cases of collagenous or lymphocytic gastritis and five cases of microscopic colitis.All 22 patients responded well when olmesartan was discontinued, with a mean weight gain of 12.2 kg (26.9 lb). Intestinal recovery or improvement was confirmed in all 18 patients who later underwent follow-up biopsies.Researchers concluded that olmesartan may be associated with severe spruelike enteropathy

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