| Liquorice-induced sodium retention. Merely an acquired condition of apparent mineralocorticoid excess? A case report. | |
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MedLine Citation:
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PMID: 11202632 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Excessive ingestion of liquorice may result in sodium retention, hypertension, hypokalemia, and suppression of renin and aldosterone. Similarities between liquorice-induced effects and congenital apparent mineralocorticoid excess have recently been emphasized, as in both conditions, reduced activity of the enzyme 11 beta-hydroxysteroid dehydrogenase type 2 allows cortisol to act as a potent mineralocorticoid. We report a case of generalized edema without any increase in blood pressure, with biochemical and hormonal features of apparent mineralocorticoid excess, in a young woman who had been ingesting substantial amounts of liquorice for several years. Liquorice-induced wide-spread edema without hypertension in our patient, as well as in a few other cases previously reported, and the more common occurrence of edema associated with hypertension challenge the current explanation of liquorice syndrome as a purely acquired apparent mineralocorticoid excess. Indeed, in both congenital apparent and true mineralocorticoid excess, edema is typically absent, as a result of the sodium escape phenomenon. As pressure-natriuresis may be an essential mechanism accounting for the sodium escape phenomenon, some component of liquorice could partially or completely oppose the circulatory response that converts liquorice-induced sodium retention into blood pressure elevation. In patients with unexplained generalized edema and hypokalemia without hypertension, liquorice ingestion should be carefully investigated and the renin-aldosterone system should be assayed. |
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Authors:
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A Negro; E Rossi; G Regolisti; F Perazzoli |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Annali italiani di medicina interna : organo ufficiale della Società italiana di medicina interna Volume: 15 ISSN: 0393-9340 ISO Abbreviation: Ann. Ital. Med. Int. Publication Date: 2000 Oct-Dec |
Date Detail:
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Created Date: 2001-02-01 Completed Date: 2001-02-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8806705 Medline TA: Ann Ital Med Int Country: Italy |
Other Details:
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Languages: eng Pagination: 296-300 Citation Subset: IM |
Affiliation:
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II Divisione di Medicina Interna, Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Pressure / physiology Edema / blood, etiology Female Glycyrrhiza / adverse effects* Humans Hypernatremia / blood, etiology* Mineralocorticoids / metabolism Plants, Medicinal* Sodium / urine |
| Chemical | |
Reg. No./Substance:
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0/Mineralocorticoids; 7440-23-5/Sodium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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