Work

First Description of Sprue-Like Enteropathy due to Azilsartan: A Case Report

Year: 2025

Type: article

Abstract: Introduction: Sartan-induced enteropathy is an uncommon side effect of treatment with angiotensin II receptor antagonists (ARBs), which has predominantly been described for olmesartan. Case Presentation: For the first time, we describe sartan-induced enteropathy as an adverse drug reaction associated with azilsartan in a 74-year-old male patient who was admitted to the hospital twice within 5 months because of excessive non-bloody diarrhea and weight loss. In this case, histopathological findings of intraepithelial lymphocytosis and intestinal villous atrophy resembled celiac disease; however, celiac disease-specific antibodies remained negative, and a gluten-free diet did not result in significant clinical recovery, while symptoms stopped rapidly after stopping azilsartan. When the patient was seen 5 months later, he was free of clinical symptoms, and histological changes disappeared after stopping azilsartan. Conclusion: This case illustrates sprue-like enteropathy as a potential side effect of azilsartan, emphasizing to consider this differential diagnosis in ARB-treated patients with chronic diarrhea. The causality of our findings was confirmed by drug de-challenge and re-challenge resulting in typical histological changes.

Source: Case Reports in Gastroenterology

DOI: 10.1159/000545217

Authors: Luisa Stoeckli, Markus Koster, Tugce Tuerkmen-Uthayanan, Sergio Cogliatti, Stephan Brand

Institution: Kantonsspital St. Gallen

Language: English

Topic: Celiac Disease Research and Management

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,030