@article{ijcd2014225,
author={Freeman, Hugh James},
title={Drug-induced Sprue-like Intestinal Disease},
journal={International Journal of Celiac Disease},
volume={2},
number={2},
pages={49--53},
year={2014},
url={http://pubs.sciepub.com/ijcd/2/2/5},
issn={2328-3955},
abstract={Celiac disease is a gluten-dependent small intestinal disorder with characteristic, but non-specific histopathological features. A number of disorders may cause similar changes in small intestinal biopsies, but fail to respond to a gluten-free diet. Traditionally, infectious agents, such as giardiasis, were often believed to be responsible, but in many patients with a sprue-like intestinal disorder, other causes were detected. The list continues to expand with the emergence of ˇ°newˇ± diseases, including transplant enteropathy, distinct immune deficiency syndromes and postcolectomy enteritis, as well as new treatments. Many medications may cause a sprue-like small intestinal mucosal inflammatory process. Alcohol, antibiotics (eg., neomycin), non-steroidal anti-inflammatory drugs (eg., sulindac), stathmokinetic and chemotherapeutic agents (eg., colchicine, vincristine, methotrexate) and immunosuppressive medications (eg., azathioprine, mycophenolate mofetil) may all cause sprue-like small intestinal mucosal changes. A number of ˇ°newˇ± drugs have also been recently recognized to cause a sprue-like intestinal disease. These include pharmaceuticals, such as olmesartan, an angiotensin II receptor antagonist used in treatment of hypertension, and biologicals, specifically ipilimumab, a humanized monoclonal antibody designed to overcome cytotoxic T-lymphocyte antigen-4, used in treatment of some advanced malignancies, including malignant melanoma. Increased physician awareness for medication-related sprue-like intestinal disease is critical as the list of emerging and novel medications expands.},
doi={10.12691/ijcd-2-2-5}
publisher={Science and Education Publishing}
}