Seronegative Intestinal Villous Atrophy: A Diagnostic Challenge
Celiac disease is the most important cause of intestinal villous atrophy. Seronegative intestinal villous atrophy, including those that are nonresponsive to a gluten-free diet, is a diagnostic challenge. In these cases, before establishing the diagnosis of seronegative celiac disease, alternative et...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2016/6392028 |
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| author | Cláudio Martins Cristina Teixeira Suzane Ribeiro Daniel Trabulo Cláudia Cardoso João Mangualde Ricardo Freire Ana Luísa Alves Élia Gamito Isabelle Cremers Ana Paula Oliveira |
| author_facet | Cláudio Martins Cristina Teixeira Suzane Ribeiro Daniel Trabulo Cláudia Cardoso João Mangualde Ricardo Freire Ana Luísa Alves Élia Gamito Isabelle Cremers Ana Paula Oliveira |
| author_sort | Cláudio Martins |
| collection | DOAJ |
| description | Celiac disease is the most important cause of intestinal villous atrophy. Seronegative intestinal villous atrophy, including those that are nonresponsive to a gluten-free diet, is a diagnostic challenge. In these cases, before establishing the diagnosis of seronegative celiac disease, alternative etiologies of atrophic enteropathy should be considered. Recently, a new clinical entity responsible for seronegative villous atrophy was described—olmesartan-induced sprue-like enteropathy. Herein, we report two uncommon cases of atrophic enteropathy in patients with arterial hypertension under olmesartan, who presented with severe chronic diarrhea and significant involuntary weight loss. Further investigation revealed intestinal villous atrophy and intraepithelial lymphocytosis. Celiac disease and other causes of villous atrophy were ruled out. Drug-induced enteropathy was suspected and clinical improvement and histologic recovery were verified after olmesartan withdrawal. These cases highlight the importance for clinicians to maintain a high index of suspicion for olmesartan as a precipitant of sprue-like enteropathy. |
| format | Article |
| id | doaj-art-33643b42c7b944ea85e45cab174a8445 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-33643b42c7b944ea85e45cab174a84452025-02-03T01:11:29ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362016-01-01201610.1155/2016/63920286392028Seronegative Intestinal Villous Atrophy: A Diagnostic ChallengeCláudio Martins0Cristina Teixeira1Suzane Ribeiro2Daniel Trabulo3Cláudia Cardoso4João Mangualde5Ricardo Freire6Ana Luísa Alves7Élia Gamito8Isabelle Cremers9Ana Paula Oliveira10Department of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalDepartment of Gastroenterology, Setúbal Hospital Center, São Bernardo Hospital, Setúbal, PortugalCeliac disease is the most important cause of intestinal villous atrophy. Seronegative intestinal villous atrophy, including those that are nonresponsive to a gluten-free diet, is a diagnostic challenge. In these cases, before establishing the diagnosis of seronegative celiac disease, alternative etiologies of atrophic enteropathy should be considered. Recently, a new clinical entity responsible for seronegative villous atrophy was described—olmesartan-induced sprue-like enteropathy. Herein, we report two uncommon cases of atrophic enteropathy in patients with arterial hypertension under olmesartan, who presented with severe chronic diarrhea and significant involuntary weight loss. Further investigation revealed intestinal villous atrophy and intraepithelial lymphocytosis. Celiac disease and other causes of villous atrophy were ruled out. Drug-induced enteropathy was suspected and clinical improvement and histologic recovery were verified after olmesartan withdrawal. These cases highlight the importance for clinicians to maintain a high index of suspicion for olmesartan as a precipitant of sprue-like enteropathy.http://dx.doi.org/10.1155/2016/6392028 |
| spellingShingle | Cláudio Martins Cristina Teixeira Suzane Ribeiro Daniel Trabulo Cláudia Cardoso João Mangualde Ricardo Freire Ana Luísa Alves Élia Gamito Isabelle Cremers Ana Paula Oliveira Seronegative Intestinal Villous Atrophy: A Diagnostic Challenge Case Reports in Gastrointestinal Medicine |
| title | Seronegative Intestinal Villous Atrophy: A Diagnostic Challenge |
| title_full | Seronegative Intestinal Villous Atrophy: A Diagnostic Challenge |
| title_fullStr | Seronegative Intestinal Villous Atrophy: A Diagnostic Challenge |
| title_full_unstemmed | Seronegative Intestinal Villous Atrophy: A Diagnostic Challenge |
| title_short | Seronegative Intestinal Villous Atrophy: A Diagnostic Challenge |
| title_sort | seronegative intestinal villous atrophy a diagnostic challenge |
| url | http://dx.doi.org/10.1155/2016/6392028 |
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