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Hypertensive crisis with 2 target organ impairment induced by glycyrrhizin: A case report.

Abstract Glycyrrhizin is the main active component of licorice. Licorice and glycyrrhizin induced hypertension has been widely reported, yet licorice and glycyrrhizin induced hypertensive crisis has been rarely known.
PMID
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An Unusual Case of Licorice-Induced Hypertensive Crisis.

Authors

Mayor MeshTerms

Glycyrrhizic Acid

Hypertension, Malignant

Hypertensive Retinopathy

Kidney Diseases

Keywords
Journal Title medicine
Publication Year Start




PMID- 29538199
OWN - NLM
STAT- MEDLINE
DCOM- 20180321
LR  - 20180321
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 11
DP  - 2018 Mar
TI  - Hypertensive crisis with 2 target organ impairment induced by glycyrrhizin: A
      case report.
PG  - e0073
LID - 10.1097/MD.0000000000010073 [doi]
AB  - RATIONALE: Glycyrrhizin is the main active component of licorice. Licorice and
      glycyrrhizin induced hypertension has been widely reported, yet licorice and
      glycyrrhizin induced hypertensive crisis has been rarely known. PATIENT CONCERNS:
      The case of this report was a 47-year-old woman, who took 225 mg of glycyrrhizin 
      daily for 3 years due to primary biliary cholangitis. She was found to have a
      dramatically elevated blood pressure of about 230/110 mmHg without a history of
      hypertension and was referred to the emergency department. DIAGNOSES:
      Hypokalemia, hypertensive retinopathy, and nephropathy were found during the
      following work-up. Since no other risk factors of hypertension were identified,
      she was suspected to have glycyrrhizin induced pseudo-hyperaldosteronism.
      INTERVENTIONS: Glycyrrhizin was discontinued. Intravenous sodium nitroprusside
      was used during the first few days. Nifedipine and irbesartan were taken after
      discharge, and the dosage was reduced gradually under supervision. OUTCOMES: She 
      stopped all the anti-hypertensive drugs 6 months since glycyrrhizin was stopped. 
      Her blood pressure was about 110/60 mmHg after repetitive measurement. Her serum 
      potassium and urine albumin/creatinine ratio were also normalized. LESSONS:
      Licorice and glycyrrhizin induced hypertension due to pseudo-hyperaldosteronism
      has been widely reported, yet only 3 cases reported that excessive consumption of
      licorice could lead to hypertensive emergencies. This is the first case that
      glycyrrhizin induced hypertensive crisis with target organ impairment. By
      presenting this case, we remind clinicians of glycyrrhizin induced hypertension, 
      a condition which could lead to medical emergencies.
FAU - Li, Jing
AU  - Li J
AD  - Department of Endocrinology and Metabolism.
FAU - Fan, Xiaoli
AU  - Fan X
AD  - Department of Gastroenterology and Hepatology, West China Hospital of Sichuan
      University, Chengdu, Sichuan Province, China.
FAU - Wang, Qin
AU  - Wang Q
AD  - Department of Endocrinology and Metabolism.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Biphenyl Compounds)
RN  - 0 (Tetrazoles)
RN  - 169D1260KM (Nitroprusside)
RN  - 6FO62043WK (Glycyrrhizic Acid)
RN  - I9ZF7L6G2L (Nifedipine)
RN  - J0E2756Z7N (irbesartan)
SB  - AIM
SB  - IM
MH  - Anti-Inflammatory Agents/administration & dosage/adverse effects
MH  - Antihypertensive Agents/administration & dosage
MH  - Biphenyl Compounds/*administration & dosage
MH  - Blood Pressure/drug effects
MH  - Cholangitis/drug therapy
MH  - Female
MH  - *Glycyrrhizic Acid/administration & dosage/adverse effects
MH  - Humans
MH  - Hyperaldosteronism/chemically induced/diagnosis
MH  - *Hypertension, Malignant/chemically induced/drug therapy
MH  - *Hypertensive Retinopathy/diagnosis/etiology
MH  - *Kidney Diseases/diagnosis/etiology
MH  - Middle Aged
MH  - Nifedipine/*administration & dosage
MH  - Nitroprusside/*administration & dosage
MH  - Tetrazoles/*administration & dosage
MH  - Treatment Outcome
MH  - Withholding Treatment
EDAT- 2018/03/15 06:00
MHDA- 2018/03/22 06:00
CRDT- 2018/03/15 06:00
PHST- 2018/03/15 06:00 [entrez]
PHST- 2018/03/15 06:00 [pubmed]
PHST- 2018/03/22 06:00 [medline]
AID - 10.1097/MD.0000000000010073 [doi]
AID - 00005792-201803160-00005 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Mar;97(11):e0073. doi: 10.1097/MD.0000000000010073.