Chest Medicine Associates Franklin, PA
Correspondence to: William H. Fee, MD, Chest Medicine Associates, 150 Prospect Ave, Franklin, PA 16323
During my pulmonology practice, I encountered a patient who had asthma and nontropical sprue. I prescribed treatment with montelukast for this patient. To my surprise, the patient called me 1 week later to report that her sprue was completely better and that, 1 week after stopping her special gluten-free diet while remaining on montelukast, she was diarrhea free for the first time in 30 years! Her asthma also improved markedly. Taking my observation one step further, I initiated montelukast in another patient with sprue and with COPD without bronchospasm. To my amazement, her sprue also improved markedly, such that she was without diarrhea for the first time in 25 years and also on a normal diet.
Montelukast is an active leukotriene receptor antagonist that inhibits the cysteinyl leukotriene receptor.1This may certainly explain the very positive effects of montelukast on patients who have sprue.2–3 It is also important to note that, in a recent study,4 20% of patients labeled with irritable bowel syndrome really had an incomplete case of sprue. I believe that many of these patients may also benefit from treatment with montelukast.
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