Olmesartan-Induced Enteritis Mimicking Small Bowel Crohn's Disease

Drug-induced enteritis and colitis are commonly included in the differential diagnosis for inflammatory bowel disease and olmesartan, an angiotensin-II receptor blocking antihypertensive medication, has been implicated in numerous cases. Typical findings of olmesartan-associated enteropathy mimic that of celiac disease with histology revealing villous blunting or atrophy, though a minority of patients present with an inflammatory phenotype that may be characterized by erythematous patches, cobblestoning, and ulceration. We present a case of olmesartan-associated enteropathy in a 79-year-old woman who initially presented with severe malabsorption and was found to have features initially concerning for upper gastrointestinal Crohn’s disease.