A 75-year-old woman was admitted to our department for weight loss (25 kg in 10 months) and chronicdiarrhea (> 6 months). In history: hypertension in Olmesartan 20 mg/day, multinodular goiter. The patient was already tested for anti-transglutaminase antibodies (negative, IgA in normal range) but EGDS showed severe duodenal villous atrophy. On suspicion of ARBsII-associated enteropathy, olmesartan was suspended with partial but not complete benefit on clinical. During hospitalization, the patient presented asthenic, occasionally soporific, severely malnourished (Table1) and with a picture of pan-cytopenia (Table1). We excluded neurological (brain CT scan), infectious (blood cultures and co-cultures) and hematologic (bone marrow biopsy) causes. Ultrasound of the intestinal loops and ileo-colonoscopy were normal. Video capsule endoscopy showed marked scalloping of DII and jejunum with extensive ulcers (Figure1). Later, she performed at referral center anterograde double-balloon enteroscopy (DBE). DBE confirmed marked atrophy and map ulcers primarily suggestive of refractory celiac disease type II/EATL with ulcerative jejunum-ileitis. Histologic examination described findings referable to chronic exacerbated, erosive enteritis, not diagnostic for celiac disease. HLA search for celiac disease was negative therefore celiac disease was excluded. Hemotransfusions and nutritional supplementation were administered in consideration of anemia and nutritional deficiency. Empiric/ex juvantibus therapy with steroid was also set up with marked improvement in symptomatology. Following hospitalization, she was re-evaluated on an outpatient basis at enteropathy referral center. Here she was first imposed high-dose steroid therapy with marked improvement and weight gain, then Azathioprine in maintenance. She was therefore discharged with a diagnosis of autoimmune enteropathy with likely previous overlap with sartane enteropathy.