Losartan is an angiotensin II receptor blocker (ARB) which may cause severe sprue‐like enteropathy (SLE) with skin manifestation. Clinicians should be informed of this side effect and its reversibility after cessation of the drug.
Merkel Cell Carcinoma (MCC) is a rare dermatologic malignancy with significant morbidity and mortality associated with metastatic disease. In this case, we discuss and extremely rare presentation of MCC with metastasis to the stomach in a patient that presented with profound anemia. Unfortunately, mortality following diagnosis of MCC with gastric metastasis approaches 67% at 4 months based on available published reports. Due to its rarity and high rate of mortality, there is a lack of available research and literature to help guide treatment of this rare presentation of MCC. This case report presents a positive outcome associated with a partial gastrectomy for the treatment of symptomatic MCC with gastric metastasis and continued survival with persistently stable hemoglobin at 12 months. Key clinical message: Anemia may be a significant cause of the morbidity and mortality associated with MCC with gastric metastasis. Our case demonstrates a positive outcome associated with partial gastric resection and presents a possible treatment option for this rare disease process.
Angiotensin receptor antagonist associated enteropathy is becoming
increasingly prevalent within the literature. We report a case of
sprue-like enteropathy associated with Losartan with a unique cutaneous
manifestation. Our case of Losartan associated enteropathy further
suggests that sprue-like disease may be a class effect of ARBs.
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