Month: June 2012

The antihypertensive olmesartan seems to have played a role in the development of otherwise unexplained spruelike enteropathy in 22 patients, according to a report in the Mayo Clinic Proceedings.

The patients, all of whom were taking olmesartan, were seen at the Mayo Clinic for evaluation of chronic severe diarrhea that had been present for a median of 18 months. Nausea and vomiting were present in two thirds, as was fatigue; abdominal pain was present in half. Treatment with a gluten-free diet and corticosteroids was ineffective. When olmesartan was withdrawn, the diarrhea resolved, and changes seen on intestinal biopsies also resolved.

The authors speculate that the delay between starting olmesartan and the onset of enteropathy (average, 3 years) suggests some effect of olmesartan on cell-mediated immunity rather than a type I hypersensitivity reaction. Their case series does not prove causality, they write, but they encourage physicians to consider medications as a cause when evaluating diarrheal syndromes.

Source: May Clinic Proceedings article

A team of interventional cardiologists at the Rigshopitalet University Hospital in Copenhagen, Denmark    have become the first to implant a new bioprosthetic mitral valve into a person via a transcatheter approach. They implanted the valve as a compassionate treatment into an 86-year-old male suffering from severe mitral regurgitation (MR 4+).  Currently, percutaneous valve replacement, increasingly done in the aortic and pulmonary valves, but has remained elusive for the mitral valve.     The valve used in Denmark was the CardiAQ prosthesis (CardiAQ Valve Technologies, Winchester, MA). The company says its technology, which it describes as “self-conforming and self-anchoring,” is designed to make nonsurgical mitral heart valve replacement a future alternative to open heart surgical replacement and repair.

If it proves successful, this could boost the entire field of percutaneous options for the treatment of mitral-valve disease.