Schreurs H, Breynaert C, De Hertogh G, Wauters L
Department of Internal medicine, University Hospitals Leuven, Leuven, Belgium.
Department of Pathology, University Hospitals Leuven, Leuven, Belgium.
Acta Gastroenterol Belg. 2025 Apr-Jun;88(2):203-206. doi: 10.51821/88.1.13942.
Olmesartan is an angiotensin II receptor blocker (ARB) used for the management of hypertension. We report a case of Olmesartan-associated severe gastritis and enteropathy (OAE) in a 81-year-old female patient who presented with anorexia and weight loss. After discontinuation of the drug, her symptoms improved and follow-up gastroscopy showed endoscopic improvement. Histopathology showed a reduction of eosinophils and intraepithelial lymphocytosis, but a persisting increase in mast cells. Hence, systemic mastocytosis was excluded by further investigations. To our knowledge, this is the first case report of a patient with Olmesartan-associated severe gastritis with histopathological presence of mast cells. We conclude that mast cells, like eosinophils, could be druginduced, although systemic mastocytosis must be ruled out. Future studies should focus on the link between local mast cells and gastro-intestinal diseases.
奥美沙坦是一种用于治疗高血压的血管紧张素II受体阻滞剂（ARB）。我们报告了一例81岁女性患者出现奥美沙坦相关的严重胃炎和肠病（OAE），该患者表现为厌食和体重减轻。停用该药物后，她的症状有所改善，后续胃镜检查显示内镜情况有所改善。组织病理学显示嗜酸性粒细胞减少和上皮内淋巴细胞增多，但肥大细胞持续增加。因此，通过进一步检查排除了系统性肥大细胞增多症。据我们所知，这是首例有组织病理学证据显示存在肥大细胞的奥美沙坦相关严重胃炎患者的病例报告。我们得出结论，肥大细胞与嗜酸性粒细胞一样，可能是药物诱导的，尽管必须排除系统性肥大细胞增多症。未来的研究应聚焦于局部肥大细胞与胃肠道疾病之间的联系。
