Case of olmesartan-associated enteropathy and transient positive antitissue transglutaminase serology

BMJ Case Rep. 2018 Dec 13;11(1):e225518. doi: 10.1136/bcr-2018-225518.

Abstract

Olmesartan-associated enteropathy (OAE) is increasingly being recognised as a major differential diagnosis in patients with villous atrophy and negative coeliac disease (CD) serology. OAE and positive coeliac markers have rarely been reported. We report a case of diarrhoea and small bowel villous blunting associated with a transient elevation of antitissue transglutaminase antibody (ATTG). On discontinuation of olmesartan, symptoms improved, repeat biopsies were normal and levels of ATTG also returned normal. We discuss a possible explanation for the transient elevation in ATTG and the significance of considering OAE/CD overlap.

Keywords: coeliac disease; drug interactions; drugs: gastrointestinal system; gastrointestinal system; malabsorption.

Publication types

  • Case Reports

MeSH terms

  • Antibodies / blood*
  • Antibodies / immunology
  • Antihypertensive Agents / adverse effects*
  • Atrophy / immunology
  • Atrophy / pathology
  • Celiac Disease / chemically induced*
  • Celiac Disease / diagnosis*
  • Celiac Disease / immunology
  • Diagnosis, Differential
  • Female
  • Humans
  • Imidazoles / adverse effects*
  • Intestine, Small / immunology
  • Intestine, Small / pathology
  • Middle Aged
  • Tetrazoles / adverse effects*
  • Transglutaminases / immunology

Substances

  • Antibodies
  • Antihypertensive Agents
  • Imidazoles
  • Tetrazoles
  • olmesartan
  • Transglutaminases