Case of olmesartan-associated enteropathy and transient positive antitissue transglutaminase serology

Abstract

Olmesartan-associated enteropathy (OAE) is increasingly being recognised as a major differential diagnosis in patients with villous atrophy and negative coeliac disease (CD) serology OAE and positive coeliac markers have rarely been reported We report a case of diarrhoea and small bowel villous blunting associated with a transient elevation of antitissue transglutaminase antibody (ATTG) On discontinuation of olmesartan, symptoms improved, repeat biopsies were normal and levels of ATTG also returned normal We discuss a possible explanation for the transient elevation in ATTG and the significance of considering OAE/CD overlap.