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Case Reports
. 2020 Oct-Dec;16(4):508-510.
doi: 10.4183/aeb.2020.508.

Licorice-induced apparent mineralocorticoid excess causing persistent hypertension and hypokalemia

Affiliations
Case Reports

Licorice-induced apparent mineralocorticoid excess causing persistent hypertension and hypokalemia

N Awad et al. Acta Endocrinol (Buchar). 2020 Oct-Dec.

Abstract

Chronic ingestion of licorice is known to cause numerous metabolic and electrolyte disturbances. Severe hyponatremia, hypertension, and hypokalemia as well as metabolic alkalosis are amongst the most common consequences of chronic ingestion resulting in an apparent mineralocorticoid excess (AME). Treatment predominantly consists of cessation of licorice ingestion, potassium replenishment and aldosterone antagonists. Given the potentially lethal effects of chronic licorice ingestion, clinicians should be made aware of the presentation of AME and the proper management. We present the rare case of a 62-year-old male with licorice-induced apparent mineralocorticoid excess secondary to excessive licorice tea intake. Initial presentation included severe hypokalemia of 2.2mmol/L and hypertension of 180/110mmHg, while eunatremic (Na, 144meq/L).

Keywords: Glycyrrhizic acid; Licorice; apparent mineralocorticoid excess; cortisol; tea.

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References

    1. Omar HR, Komarova I, El-Ghonemi M, Fathy A, Rashad R, Abdelmalak HD, Yerramadha MR, Helal E, Camporesi EM. Licorice abuse: time to send a warning message. Ther Adv Endocrinol Metab. 2012;3(4):125–138. - PMC - PubMed
    1. Farese RV, Biglieri EG, Shackleton CH, Irony I, Gomez-Fontes R. Licorice-induced hypermineralocorticoidism. N Engl J Med. 1991;325(17):1223–1227. - PubMed
    1. Apostolakos JM, Caines LC. Apparent Mineralocorticoid Excess Syndrome: A Case of Resistant Hypertension From Licorice Tea Consumption. J Clin Hypertens (Greenwich). 2016;18(10):991–993. - PMC - PubMed
    1. Hautaniemi EJ, Tahvanainen AM, Koskela JK, Tikkakoski AJ, Kähönen M, Uitto M, Sipila K, Niemela O, Mustonen J, Porsti I. Voluntary liquorice ingestion increases blood pressure via increased volume load, elevated peripheral arterial resistance, and decreased aortic compliance. Sci Rep. 2017;7(1):10947. - PMC - PubMed
    1. Gallacher SD, Tsokolas G, Dimitropoulos I. Liquorice-induced apparent mineralocorticoid excess presenting in the emergency department. Clin Med (Lond). 2017;17(1):43–45. - PMC - PubMed

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