eng Science and Education Publishing International Journal of Celiac Disease 2334-3486 2021-05-18 9 2 35 37 10.12691/ijcd-9-2-6 IJCD2021926 article Hugh James Freeman hugfree@shaw.ca 1 Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada Collagenous sprue is an unusual small intestinal mucosal disorder characterized by flattened small intestinal mucosa, unusual sub-epithelial collagen deposits, increased intra-epithelial lymphocytes, often denuded epithelial cells and resistance to therapy, including a gluten-free diet. The disorder is heterogeneous with several potential causes now identified. Similar to sprue-like intestinal disease, collagenous sprue may be caused or precipitated by different pharmaceutical agents. Olmesartan, an angiotensin II inhibitor, often employed in treatment of hypertension, may cause a drug-induced form of sprue-like small intestinal disease with the pathological features of untreated celiac disease refractory to gluten-free diet treatment. In addition, collagenous sprue may be precipitated by olmesartan. Recognition and cessation of the medication has led to resolution of the small intestinal mucosal disorder without steroids or other treatment. http://pubs.sciepub.com/ijcd/9/2/6/ijcd-9-2-6.pdf collagenous sprue sprue-like intestinal disease drug-induced small bowel disease malabsorption olmesartan