Capsule endoscopy for diagnosis of celiac disease

Alimetov, Anar Y.; Поляков, П. П.; Оноприев, А. В.; Avakimyan, Andrey V.; Занин, С. А.; Каде, А. Х.

doi:10.26442/00403660.2019.02.000068

Cited by 1 publication

(1 citation statement)

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“…Rather, it is possible that Olmesartan enteropathy could share with celiac disease the patchiness and duodenal-jejunal variations of the mucosal abnormalities [14]. On the other hand, also in celiac disease, video capsule endoscopy has been indicated in the case of discordant results between serological and histological investigations as well as in patients with nonresponsive or refractory disorder [15].…”

Section: Discussionmentioning

confidence: 99%

Olmesartan Associated Enteropathy: Usefulness of Video Capsule Endoscopy in a Case With Doubtful Upper Endoscopic/Histological Picture

Abbruzzi

Loconte

Carparelli

et al. 2020

CDS

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Background: Olmesartan, an antihypertensive drug, may be associated with a severe “sprue-like enteropathy”. Objectives: To report a case of Olmesartan enteropathy demonstrated by video capsule endoscopy distally from the second duodenum along with the whole small bowel before and after drug withdrawal. Case Presentation: A 81-years-old man was referred for asthenia, chronic watery diarrhea and anasarca (ascites, pleural effusion and edemas of superior and inferior limb). The only comorbidity was hypertension treated with Olmesartan. All causes of infective and inflammatory chronic diarrhea were investigated and excluded. Upper endoscopy was normal; histological examination of the second portion of the duodenum showed moderate and patchy infiltration of lymphocytes at mucosal and intra-epithelial level with intermittent partial villous atrophy. The possibility of adverse drug reaction, estimated by Naranjo scale, showed a score of 7, indicating a strong probability. Olmesartan was then withdrawn. However, because of severe clinical general condition, we preferred to corroborate our diagnostic work-up by a non-invasive investigation, i.e. video capsule endoscopy, which showed jejunal and ileal mucosal alterations (mosaic pattern, diffuse hyperemia, severe edema, consequent apparent reduced lumen, diffuse thickening of intestinal folds, multiple erosions, patchy lymphangectasia). After 14 days, the resolution of anasarcatic state and hydroelectrolytic imbalances was observed. Nine months later, small-bowel video-capsule demonstrated mild mucosal hyperaemia and mosaic pattern. Conclusions: Our case could give new insights in the field of Olmesartan associated enteropathy by highlighting the possibility of distally main lesion location and, therefore, the usefulness of video capsule endoscopy in the presence of doubtful diagnostic features.

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Section: Discussionmentioning

confidence: 99%