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Pseudohyperaldosteronism Due to Licorice: A Practice-Based Learning from a Case Series.
Sabbadin, Chiara; Graziani, Andrea; Bavaresco, Alessandro; Mazzeo, Pierluigi; Tizianel, Irene; Ceccato, Filippo; Armanini, Decio; Barbot, Mattia.
Afiliación
  • Sabbadin C; Unit of Endocrinology, University Hospital of Padua, 35128 Padua, Italy.
  • Graziani A; Department of Medicine (DIMED), University of Padua, 35128 Padua, Italy.
  • Bavaresco A; Unit of Endocrinology, University Hospital of Padua, 35128 Padua, Italy.
  • Mazzeo P; Department of Medicine (DIMED), University of Padua, 35128 Padua, Italy.
  • Tizianel I; Unit of Endocrinology, University Hospital of Padua, 35128 Padua, Italy.
  • Ceccato F; Department of Medicine (DIMED), University of Padua, 35128 Padua, Italy.
  • Armanini D; Unit of Endocrinology, University Hospital of Padua, 35128 Padua, Italy.
  • Barbot M; Department of Medicine (DIMED), University of Padua, 35128 Padua, Italy.
Int J Mol Sci ; 25(13)2024 Jul 07.
Article en En | MEDLINE | ID: mdl-39000561
ABSTRACT
Pseudohyperaldosteronism (PHA) is characterized by hypertension, hypokalemia, and a decrease in plasma renin and aldosterone levels. It can be caused by several causes, but the most frequent is due to excess intake of licorice. The effect is mediated by the active metabolite of licorice, glycyrrhetinic acid (GA), which acts by blocking the 11-hydroxysteroid dehydrogenase type 2 and binding to the mineralocorticoid receptor (MR) as an agonist. The management of licorice-induced PHA depends on several individual factors, such as age, gender, comorbidities, duration and amount of licorice intake, and metabolism. The clinical picture usually reverts upon licorice withdrawal, but sometimes mineralocorticoid-like effects can be critical and persist for several weeks, requiring treatment with MR blockers and potassium supplements. Through this case series of licorice-induced PHA, we aim to increase awareness about exogenous PHA, and the possible risk associated with excess intake of licorice. An accurate history is mandatory in patients with hypertension and hypokalemia to avoid unnecessary testing. GA is a component of several products, such as candies, breath fresheners, beverages, tobacco, cosmetics, and laxatives. In recent years, the mechanisms of action of licorice and its active compounds have been better elucidated, suggesting its benefits in several clinical settings. Nevertheless, licorice should still be consumed with caution, considering that licorice-induced PHA is still an underestimated condition, and its intake should be avoided in patients with increased risk of licorice toxicity due to concomitant comorbidities or interfering drugs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ácido Glicirretínico / Glycyrrhiza / Hiperaldosteronismo Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Mol Sci Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ácido Glicirretínico / Glycyrrhiza / Hiperaldosteronismo Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Mol Sci Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza