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奥美沙坦:一种鲜为人知的腹泻病因。

Olmesartan: A Little-Known Cause of Diarrhoea.

作者信息

Serôdio Joana, Carneiro Joana, Veiga Manuel, Ferreira António

机构信息

Internal Medicine Department, Unidade Local de Saúde do Alto Minho, Portugal.

Anatomical Pathology Department, Unidade Local de Saúde do Alto Minho, Portugal.

出版信息

Eur J Case Rep Intern Med. 2019 Jun 28;6(7):001143. doi: 10.12890/2019_001143. eCollection 2019.

Abstract

UNLABELLED

Olmesartan's sprue-like enteropathy was first described in 2012 and typically presents with diarrhoea, weight loss, nausea, vomiting, low albumin and histological evidence of intestinal villous atrophy. Coeliac disease is one of the main differential diagnoses and should be excluded. We present the clinical case of a 63-year-old man treated with olmesartan for 10 years who presented with a 2-month history of diarrhoea and was diagnosed with olmesartan's enteropathy. This case highlights the need for clinical suspicion of this new entity in order to reduce the associated morbidity and unnecessary costly investigations.

LEARNING POINTS

Sprue-like enteropathy associated with olmesartan is a recently described and recognized disease.This condition should be suspected in patients taking olmesartan who have chronic diarrhoea, intestinal villous atrophy and negative serology for coeliac disease, or an absent response to a gluten-free diet.Early suspicion of olmesartan's enteropathy can reduce the associated morbidity and avoid costly investigation.

摘要

未标注

奥美沙坦相关的口炎性腹泻样小肠病于2012年首次被描述,通常表现为腹泻、体重减轻、恶心、呕吐、低白蛋白血症以及肠道绒毛萎缩的组织学证据。乳糜泻是主要的鉴别诊断之一,应予以排除。我们报告了一例63岁男性的临床病例,该患者接受奥美沙坦治疗10年,出现了2个月的腹泻病史,并被诊断为奥美沙坦相关小肠病。该病例强调了临床怀疑这一新疾病实体的必要性,以降低相关发病率和避免不必要的昂贵检查。

学习要点

与奥美沙坦相关的口炎性腹泻样小肠病是一种最近被描述和认识的疾病。对于服用奥美沙坦且患有慢性腹泻、肠道绒毛萎缩以及乳糜泻血清学检查阴性或对无麸质饮食无反应的患者,应怀疑患有此病。早期怀疑奥美沙坦相关小肠病可降低相关发病率并避免昂贵的检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3075/6663053/e90049b081ff/1143_Fig1.jpg

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