Israel Hanna, Hartig Andreas, Siebolts Udo, Wickenhauser Claudia, Tannapfel Andrea, Ernst Friedrich, Wahl Uwe
BG Klinikum Bergmannstrost Halle, Medizinische Klinik.
Universitätsklinikum Halle (Saale), Institut für Pathologie.
Dtsch Med Wochenschr. 2019 Mar;144(6):394-397. doi: 10.1055/a-0830-6521. Epub 2019 Mar 14.
A 72-year-old female presented with a therapy-resistant diarrhea.
In the case of negative stool cultures and inconspicuous radiological imaging, further endoscopic diagnostics were performed. Histological implicated the image of a celiac disease in the duodenum and lymphocytic colitis reaching into the terminal ileum. In the case of negative antibody detection for celiac disease, a medication side effect was considered by differential diagnosis.
When olmesartan was discontinued, she developed a rapid improvement of the symptoms.
For the angiotensin receptor antagonist olmesartan, the occurrence of a sprue-like enteropathy has rarely described. Microscopic colitis is an exception.
一名72岁女性出现对治疗耐药的腹泻。
粪便培养结果为阴性且放射影像学检查无异常，遂进一步进行内镜诊断。组织学检查显示十二指肠有乳糜泻图像，淋巴细胞性结肠炎累及回肠末端。乳糜泻抗体检测为阴性，鉴别诊断考虑药物副作用。
停用奥美沙坦后，她的症状迅速改善。
对于血管紧张素受体拮抗剂奥美沙坦，很少有报道其会引发类口炎性腹泻。显微镜下结肠炎是个例外。
