Fujisawa Mizuho, Yoshizaki Tetsuya, Urakami Satoshi, Ashizaki Risa, Nishikawa Eri, Tanabe Hiroshi, Hoki Shinya, Ishida Ryosuke, Hori Hitomi, Ueda Chise, Abe Hirofumi, Takao Madoka, Morita Yoshinori, Toyonaga Takashi, Kodama Yuzo
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Division of Gastroenterology, International Clinical Cancer Research Center, Kobe University, Japan.
Intern Med. 2025 Jun 15;64(12):1843-1848. doi: 10.2169/internalmedicine.4551-24. Epub 2024 Nov 28.
A 61-year-old woman who had been taking olmesartan for 7 years complained of epigastric pain, diarrhea, loss of appetite, and weight loss. Esophagogastroduodenoscopy revealed roughened mucosa and erosions in the stomach and duodenum. An endoscopic biopsy failed to identify the cause of the mucosal disorder. Small-bowel capsule endoscopy revealed villous atrophy in the small bowel, which led to suspicion of olmesartan-associated sprue-like enteropathy and gastritis. After the discontinuation of olmesartan, the symptoms and gastric mucosal findings improved. A final diagnosis of olmesartan-associated gastritis was confirmed. Olmesartan-associated gastritis should be considered in patients taking olmesartan for upper gastrointestinal symptoms.
一名服用奥美沙坦7年的61岁女性主诉上腹部疼痛、腹泻、食欲不振和体重减轻。食管胃十二指肠镜检查显示胃和十二指肠黏膜粗糙及糜烂。内镜活检未能确定黏膜病变的原因。小肠胶囊内镜检查显示小肠绒毛萎缩，这导致怀疑为奥美沙坦相关的口炎性腹泻样肠病和胃炎。停用奥美沙坦后，症状和胃黏膜表现有所改善。最终确诊为奥美沙坦相关胃炎。对于服用奥美沙坦出现上消化道症状的患者，应考虑奥美沙坦相关胃炎。
