Introduction:
Angiotensin receptor blocker (ARB) induced sprue-like enteropathy is a
rare adverse effect of this class of medication but is increasingly
recognized as a potential side effect that clinicians should be aware.
The first published cases were from the Mayo Clinic in a case series of
Olmesartan induced sprue-like enteropathy. While reported clinical
manifestations of these patients included abdominal pain, severe weight
loss, chronic diarrhea, and severe electrolyte derangements, there was
no description of cutaneous manifestations. Since that time, only one
case of ARB induced sprue-like enteropathy with cutaneous manifestations
has been noted and was associated with Olmesartan, specifically.
Symptoms in the above cases resolved within 3-12 months of medication
discontinuation. Currently sprue-like enteropathy has yet to be
classified as class effect among ARBs; however, there are several cases
within the literature that advocate in favor of this idea. We report a
case of sprue-like enteropathy associated with losartan with a unique
cutaneous manifestation.