Maier Hans, Hehemann Karlheinz, Vieth Michael
Cesk Patol. 2015;51(2):87-8.
An 83-year-old woman with hypertension received the angiotensin-II receptor type 1 blocker (ARB) eprosartan for more than 10 years. Six months ago, the dosage of the drug was doubled, and the patient reported a sudden onset of diarrhea. Duodenal biopsies showed a celiac disease-like pathology with flattened mucosa and an increase of intraepithelial lymphocytes and eosinophils, but serology of celiac disease remained negative. Celiac disease-like changes have been previously reported to be associated with other ARBs. This is the first case following eprosartan medication. In celiac-disease-like pathology of the small bowel with negative serology, drug-induced changes, for example due to ARBs, should be excluded.
一位83岁的高血压女性服用血管紧张素II 1型受体阻滞剂（ARB）依普罗沙坦超过10年。6个月前，该药剂量加倍，患者报告突然出现腹泻。十二指肠活检显示有乳糜泻样病理改变，黏膜扁平，上皮内淋巴细胞和嗜酸性粒细胞增多，但乳糜泻血清学检查仍为阴性。此前有报道称，乳糜泻样改变与其他ARB有关。这是服用依普罗沙坦后的首例病例。在血清学检查阴性的小肠乳糜泻样病理改变中，应排除药物引起的改变，例如由ARB引起的改变。
