A Rare Case of Olmesartan-Associated Enteropathy Successfully Managed With Steroid Taper

Olmesartan is a commonly used antihypertensive medication belonging to the class of angiotensin II receptor blockers. Though generally well-tolerated, olmesartan can rarely cause olmesartan-associated enteropathy (OAE) with non-bloody diarrhea, weight loss, abdominal pain, and vomiting. Patients may develop months years after drug initiation. In severe cases, patients complications that require hospitalization. Diagnosis often delayed due unfamiliarity OAE, nonspecific presenting symptoms, normal-appearing gross endoscopic findings. Esophagogastroduodenoscopy (EGD) biopsy essential diagnosis, showing sprue-like intestinal villous atrophy mucosal inflammation. This report describes case 70-year-old man who presented three profuse watery diarrhea 40-pound unintentional loss. After an extensive workup, including EGD duodenal biopsies, patient was diagnosed OAE. The biopsies showed findings consistent acute chronic duodenitis, desquamation ulceration, blunting villi, pattern neutrophils. Celiac serologies anti-enterocyte antibodies were negative, further supporting diagnosis Complete resolution symptoms achieved by discontinuing administering steroid taper. Considering frequent use olmesartan, increasing occurrence wide range associated it crucial for providers recognize OAE consider early discontinuation olmesartan. approach help prevent damage, protracted unnecessary diagnostic tests, financial burdens on both healthcare system.