RESUMO
Olmesartan is an angiotensin II receptor antagonist used for the management of hypertension. This drug can lead to an enteropathy that clinically and histologically resembles coeliac disease. Symptoms may appear months or years after the introduction of the drug and usually resolve after discontinuation. The authors present a case of an 86-year-old woman with hypertension who was treated with olmesartan for 10 years. She presented to the emergency department with diarrhoea after three months of development and weight loss. The aetiological study that was conducted excluded infectious, inflammatory, endocrinological, and neoplastic causes. The pathological anatomy of the duodenal biopsy was suggestive of coeliac disease, but the serology was not compatible. The patient presented complete remission of the condition with the suspension of the drug and subsequent recrudescence when, by self-initiation, she resumed olmesartan. This case study aims to alert readers of a rare cause of enteropathy with a clinical manifestation that mimics coeliac disease. Olmesartan-induced enteropathy seems to be a diagnosis of exclusion and should be considered in patients chronically medicated with olmesartan.
RESUMO
Objective: We aimed to assess the prevalence and clinical characteristics of SARS-CoV-2 reinfections in a Spanish region. Methods: This is a retrospective observational study in all patients with SARS-CoV-2 infections in the Lleida health region from 1 March to 30 November 2020. Reinfections were classified as patients with positive SARS-CoV-2 PCR tests separated by at least 90 days plus a negative test result between both infection episodes. Primary and secondary outcomes: The primary outcome was the percentage of SARS-CoV-2 reinfections among all SARS-CoV-2 infections detected during our study period. Secondary outcomes were the clinical and sociodemographic characteristics of patients with SARS-CoV-2 reinfections. Results: Of the 27,758 patients diagnosed with SARS-CoV-2 infection in the study period, 14 were identified as coronavirus reinfection (0.050%). Of the reinfected sample, 12 patients (85.7%) were women. The median age was 41.5 years. Two patients died in the second coronavirus episode. Conclusion: The reinfection rate of SARS-CoV-2 in the Spanish region Lleida was relatively low during the observational period in 2020 (less than 1%). These data are in line with the notion that previous SARS-CoV-2 infections may offer a significant protection by so called natural immunity.
