{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:05:53Z","timestamp":1791637553182,"version":"4.3.4"},"reference-count":109,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,7]],"date-time":"2024-01-07T00:00:00Z","timestamp":1704585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although enteropathy due to angiotensin II receptor blockers (ARBs) has been known for over 10\u2009years, clinicians' awareness of this condition is still low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To systematically review the literature about clinical phenotypes, distribution of mucosal changes throughout the gastrointestinal tract and prognosis of enteropathy due to ARBs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>According to PRISMA guidelines, we searched PubMed and Embase for relevant articles up to November 6, 2023. We included full\u2010text papers, letters, case reports and case series describing enteropathy due to ARBs. Patients were classified into subgroups based on endoscopic and histological findings of different regions of the gastrointestinal tract. The protocol was registered with Open Science Framework (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/doi.org\/10.17605\/OSF.IO\/TK67C\">https:\/\/doi.org\/10.17605\/OSF.IO\/TK67C<\/jats:ext-link>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 94 articles reporting 183 cases (101 female, mean age at diagnosis 69\u2009\u00b1\u200910\u2009years). The clinical picture at diagnosis was characterised by severe diarrhoea (97%) and weight loss (84%, median \u221213\u2009kg), leading to hospital admission in 167 (95%) patients. Olmesartan (90%) was most frequently implicated. Villous atrophy (VA) was reported in 164\/183 (89%) patients. One hundred and nine had only VA, 12 had pan\u2010gastrointestinal involvement, 23 had VA and gastric involvement and 19 had VA and colon involvement (predominantly microscopic colitis). Outcomes were reported for 178\/183 (97%) patients, who all recovered clinically on ARBs withdrawal. Histological recovery occurred in all 96 patients with VA at baseline who underwent follow\u2010up duodenal biopsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Enteropathy due to ARBs is characterised by severe malabsorption often requiring hospital admission and can involve the entire gastrointestinal tract. Clinician awareness can lead to prompt diagnosis and excellent prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17855","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T06:58:51Z","timestamp":1704697131000},"page":"432-444","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Systematic review: Clinical phenotypes, histopathological features and prognosis of enteropathy due to angiotensin II receptor blockers"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8493-7698","authenticated-orcid":false,"given":"Annalisa","family":"Schiepatti","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Therapeutics University of Pavia  Pavia Italy"},{"name":"Istituti Clinici Scientifici Maugeri IRCCS Gastroenterology Unit of Pavia Institute  Pavia 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