<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2182-5173</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Medicina Geral e Familiar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Med Geral Fam]]></abbrev-journal-title>
<issn>2182-5173</issn>
<publisher>
<publisher-name><![CDATA[Associação Portuguesa de Medicina Geral e Familiar]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2182-51732022000500524</article-id>
<article-id pub-id-type="doi">10.32385/rpmgf.v38i5.13360</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Uma causa rara de diarreia: efeito pouco frequente de um medicamento comum]]></article-title>
<article-title xml:lang="en"><![CDATA[A rare cause of diarrhoea: uncommon effect of an ordinary medication]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[Rafaela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cunha]]></surname>
<given-names><![CDATA[Maria João da]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,ACeS Tâmega I - Baixo Tâmega USF Amadeo de Souza-Cardoso ]]></institution>
<addr-line><![CDATA[Amarante ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>31</day>
<month>10</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>31</day>
<month>10</month>
<year>2022</year>
</pub-date>
<volume>38</volume>
<numero>5</numero>
<fpage>524</fpage>
<lpage>529</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2182-51732022000500524&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2182-51732022000500524&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2182-51732022000500524&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A hipertensão arterial (HTA) é uma doença crónica e um dos principais fatores de risco para doenças cardiovasculares. Por essa razão, o doente hipertenso beneficia de um seguimento regular e orientado pelo seu médico de família (MF). O controlo tensional pode ser alcançado com medidas de estilo de vida ou também com recurso a terapêutica farmacológica. Desta última, salienta-se a classe dos antagonistas do recetor da angiotensina II (ARA), comummente utilizados na prática clínica pelo seu efeito anti-hipertensivo e perfil de segurança, sendo que em raras vezes pode causar diarreia crónica grave. O presente relato pretende dar a conhecer um diagnóstico raro e sensibilizar o MF para uma nova hipótese diagnóstica perante um quadro de diarreia crónica.  Descrição do caso:  Mulher, 65 anos, com antecedentes pessoais de HTA medicada com olmesartan 20 mg desde 2012, sem outros antecedentes pessoais de relevo. A doente iniciou um quadro de diarreia com um mês de evolução e que motivou inúmeras avaliações médicas. Associadamente, com queixas de cólica abdominal, náusea, vómitos, astenia e perda ponderal. Perante uma investigação em ambulatório inconclusiva e à ausência de melhoria clínica com os diversos tratamentos empíricos, a utente foi proposta para internamento para estudo etiológico. Ao longo do internamento, a descontinuação do olmesartan resultou na resolução do quadro, tendo tido alta com o diagnóstico de enteropatia sprue-like.  Comentário:  O presente caso pretende enfatizar a importância de uma anamnese completa e detalhada, relembrar os principais passos no estudo da diarreia crónica e dar a conhecer um diagnóstico raro de enteropatia sprue-like induzida pelo olmesartan. Em concordância com as características da disciplina de medicina geral e familiar, caberá ao MF o acompanhamento longitudinal destes utentes, com consequente reavaliação e vigilância das queixas. Perante este diagnóstico levanta-se um novo desafio ao MF na ulterior orientação do controlo tensional destes utentes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Arterial hypertension is a chronic condition and one of the main risk factors for cardiovascular disease. Therefore, patients presenting with this disorder benefit from regular follow-ups with their general practitioner/family doctor (FD). Blood pressure control can be achieved with lifestyle measures alone or by resorting simultaneously to pharmacological treatment. Among pharmacological options, angiotensin II receptor blockers (ARB) stand out for being commonly used due to their anti-hypertensive effect and safety profile, albeit they can rarely cause severe chronic diarrhoea. This case report intends to present a rare diagnosis and sharpen FD to a new diagnostic hypothesis in the face of chronic diarrhoea.  Case report:  A 65-year-old woman, with a personal history of arterial hypertension treated with olmesartan 20 mg since 2012 and no other relevant personal history. The patient presented with a one-month history of diarrhoea entailing several medical evaluations. Along with abdominal pain, nausea, vomiting, asthenia, and weight loss. Due to an inconclusive outpatient investigation and lack of clinical response to the multiple empirical treatments, the patient was proposed for hospital admission for further etiological study. While hospitalized, olmesartan was discontinued resulting in symptom resolution, which lead to patient discharge with the diagnosis of sprue-like enteropathy.  Conclusion:  This case intends to emphasize the importance of a complete and detailed medical history, recall the main steps in the investigation of chronic diarrhoea and disclose a rare diagnosis of sprue-like enteropathy olmesartan-induced. According to the European definition of general practice/family medicine, the FD is responsible for the longitudinal continuity of care which will involve the reassessment and monitoring of the clinical condition. Furthermore, once faced with this diagnosis, FD is encouraged to overcome the challenge of ulterior blood pressure control.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Diarreia]]></kwd>
<kwd lng="pt"><![CDATA[Hipertensão arterial]]></kwd>
<kwd lng="pt"><![CDATA[Antagonistas dos recetores da angiotensina II]]></kwd>
<kwd lng="pt"><![CDATA[Olmesartan]]></kwd>
<kwd lng="pt"><![CDATA[Efeitos adversos]]></kwd>
<kwd lng="en"><![CDATA[Diarrhoea]]></kwd>
<kwd lng="en"><![CDATA[Arterial hypertension]]></kwd>
<kwd lng="en"><![CDATA[Angiotensin II receptor blockers]]></kwd>
<kwd lng="en"><![CDATA[Olmesartan]]></kwd>
<kwd lng="en"><![CDATA[Adverse effects]]></kwd>
</kwd-group>
</article-meta>
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