{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:21:46Z","timestamp":1783441306857,"version":"3.54.6"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Angiotensin receptor blocker\u2010associated enteropathy (ARB\u2010e) is an increasingly recognised clinical entity with symptoms and histological findings identical to coeliac disease (CD). There is evidence to suggest immune\u2010mediated mucosal injury in ARB\u2010e with a high prevalence of DQ2\/DQ8; however, as IgA anti\u2010tissue transglutaminase (anti\u2010TTG) is usually negative, an insult other than TTG\u2010mediated injury is suspected. The impact of ARBs on disease activity in patients with CD is not known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effect of ARB exposure on patients with established CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A patient record search of 1142 individual patients attending a dedicated coeliac clinic from 2010 to the present identified 59 patients treated with ARB. Those with CD confirmed by serology (TTG\u00a0+\u00a0ve\/EMA\u00a0+\u00a0ve) and histopathology (Marsh criteria) were included (<jats:italic>n<\/jats:italic>\u00a0=\u00a040, 0.52%). Data collected included disease duration, compliance with gluten\u2010free diet (GFD), reported symptoms (diarrhoea, weight loss and abdominal pain), surrogate markers of absorption (Vitamin D, Iron, Calcium and Haemoglobin), in addition to anti\u2010TTG titre and histological grade at last follow up. Patients were age and sex\u2010matched in a 1:2 ratio with CD patients not taking ARBs (controls), with comparable rates of disease duration and compliance with GFD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ARB and control groups were matched in terms of age (mean 66.2\u00a0years) and gender (female 63%). Strict compliance with GFD was reported in 55% and 56%, respectively. Persistent symptoms were reported in 10\/40 (25%) of the ARB group compared with 7\/82 (9%) of controls (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0181). There were lower rates of mucosal healing (Marsh grade 0) in the ARB group (36% <jats:italic>n<\/jats:italic>\u00a0=\u00a011) compared to controls (55%, <jats:italic>n<\/jats:italic>\u00a0=\u00a033). There was no significant difference in anti\u2010TTG titres. Surrogate markers of absorption were comparable across the groups, except for Vitamin D which was lower in those taking olmesartan (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0015).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ARBs may aggravate the enteropathy and lead to increased symptoms in patients with bone fide diagnosed CD following a GFD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12117","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T16:24:49Z","timestamp":1624983889000},"page":"973-979","source":"Crossref","is-referenced-by-count":7,"title":["Coeliac disease enteropathy and symptoms may be aggravated by angiotensin receptor blockers in patients on a gluten\u2010free diet"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2542-9455","authenticated-orcid":false,"given":"Neil","family":"O'Morain","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Galway University Hospital  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2391-8757","authenticated-orcid":false,"given":"Eileen","family":"Shannon","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Galway University Hospital  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McManus","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Galway University Hospital  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Warner","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Galway University Hospital  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1692-9207","authenticated-orcid":false,"given":"Hilary","family":"Leeson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Galway University Hospital  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"O'Donovan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Galway University Hospital  Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Egan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Mayo General Hospital  Castlebar Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Byrnes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Galway University Hospital  Galway 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