Potential coeliac disease markers and autoimmunity in olmesartan induced enteropathy: A population-based study

Autor: Yamile Zabana, Maria Esteve, Sandra Agudo, Adolfo del Val, Josepa Ribes, Rocío Temiño, Rosa Madridejos, Xavier Andújar, Anna Carrasco, Santos Santaolaria, Germán Soriano, Michel Ble, Javier Molina-Infante, Lissette Batista, Fernando Fernández-Bañares, Montserrat Aceituno
Rok vydání: 2016
Předmět:
Male
Anti-TG2 IgA deposits
Tetrazoles
Disease
medicine.disease_cause
Gastroenterology
Coeliac disease
Autoimmunity
0302 clinical medicine
Enteropathy
Lymphocytes
030212 general & internal medicine
Aged
80 and over
education.field_of_study
Incidence (epidemiology)
Imidazoles
Middle Aged
Enteritis
Lymphocyte subpopulations
Sprue like
Female
030211 gastroenterology & hepatology
Olmesartan
medicine.drug
medicine.medical_specialty
Duodenum
Population
03 medical and health sciences
GTP-Binding Proteins
HLA-DQ Antigens
Internal medicine
medicine
Humans
Protein Glutamine gamma Glutamyltransferase 2
education
Antihypertensive Agents
Aged
Autoantibodies
Lupus-like disease
Transglutaminases
Hepatology
business.industry
medicine.disease
Immunoglobulin A
Discontinuation
Celiac Disease
Spain
Immunology
business
Biomarkers
Zdroj: DIGESTIVE AND LIVER DISEASE
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
ISSN: 1590-8658
DOI: 10.1016/j.dld.2015.09.014
Popis: Aims: (1) Assess the population-based incidence of severe olmesartan-associated enteropathy. (2) To describe patients of the Spanish registry. (3) Evaluate markers of potential coeliac disease and associated autoimmunity. Methods: Crude incidence rates in the area of Terrassa (Catalonia) were calculated. Clinical characteristics of patients in the Spanish registry were collected. Duodenal lymphocyte subpopulations and anti-TG2 IgA deposits were assessed in a subset of patients. Results: Annual incidence rates (2011-2014) ranged from 0 to 22 cases per 104 treated patients. Twenty patients were included in the Spanish registry. Nineteen (95%) exhibited villous atrophy and 16 (80%) had severe enteropathy. Lupus-like disease occurred during olmesartan treatment in 3 patients. HLA-DQ2/DQ8 was positive in 64%. Markers of potential coeliac disease were present in 4 out of 8 patients (positive anti-TG2 deposits and/or increased CD3+ gammadelta+ intraepithelial lymphocytes and reduced CD3-). Histopathological changes and clinical manifestations including autoimmune disorders improved after olmesartan discontinuation but not after gluten-free diet, irrespective of the presence or absence of coeliac markers. Conclusions: Incidence of severe olmesartan-associated enteropathy was low. Autoimmune phenomena were present in a subset of cases and reversed after olmesartan removal. A genetic coeliac disease background and the presence of potential coeliac markers might uncover predisposing factors. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Databáze: OpenAIRE
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