Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metabolic and toxic effects caused by prolonged daily ingestion of Liquorice are well known in the literature. Such acquisition doesn't seem to be known enough by practitioners and by common people. Besides active substances such as Glycyrrhizin , Liquorice contains even steroids similar to the adrenocortical ones; among these the most important is Beta-Glycyrrhetinic acid. This one, in vivo and in vitro, produces salt and water retention by means of a "DOCA-like" mineral-corticoid mechanism, and clear suppression of the Renin-Angiotensin-Aldosterone axis. A low plasmatic level of Renin and Aldosterone is a common feature. The clinical picture in many ways is similar to the primary Aldosteronism and for this reason the above mentioned syndrome is usually called "Pseudoaldosteronism". Symptoms and signs can be classified into the following main groups: symptoms linked with water and salt retention: oedemas, hypertension, cardiac involvement. Symptoms linked with serum Potassium depletion: asthenia, paralysis (due to Potassium deficiency), myopathy with myoglobinuria. The diagnosis is essential based on an accurate pharmacological dietetic history, aimed to recognise an excessive use of Liquorice (pure or more often as substitute) in the screening of hypertension with or without hypopotassemia. Finally, the more or less quick normalisation of blood pressure and biochemical signs--as an "ex juvantibus" criterion--is the most important reason for the diagnosis. After a wide survey of the literature, the clinical and biological picture in four patients with chronic Liquorice ingestion and Pseudoaldosteronism syndrome is described.
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PMID:[Pseudoaldosteronism caused by licorice. Review of the literature and description of 4 clinical cases]. 380 7

An 81-year-old woman had been visiting 2 hospitals for hypertension and dementia, prior to admission to our emergency room for nausea, hypertension, severe hypokalemia (K 1.29 mEq/l) and abnormal electrocardiography findings. She had been taking a Chinese herbal remedy (Yokukansan, 7.5 g/day) for the behavioral and psychological symptoms of dementia (BPSD) for 6 months before admission. On admission, she presented with metabolic alkalosis with hypokalemia, a high urinary excretion of potassium, low plasma rennin activity and hypoaldosteronism. We diagnosed pseudoaldosteronism caused by the Chinese herbal remedy Yokukansan (which includes licorice). Discontinuation of Yokukansan and the administration of potassium supplements normalized her serum potassium level within 2 weeks. However, we could not successfully control her BPSD by drugs such as tiapride hydrochloride or risperidone. BPSD is a serious problem in an aging society, with the ever-increasing incidence of dementia. The use of Yokukansan has recently been receiving attention as a new treatment modality for BPSD. Because this agent has relatively few adverse effects compared with typical antipsychotic agents, the use of Yokukansan is continuing to increase sharply. Pseudoaldosteronism, if caused by Yokukansan, may cause death by severe hypokalemia, but the early identification of hypokalemia is sometimes difficult because drug-induced hypokalemia is not dose-dependent. We think it is important to create awareness of the possible adverse effects of Yokukansan, such as hypertension and electrolyte abnormalities to make the most of this commonly used drug for the treatment of BPSD among dementia patients.
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PMID:[A case of severe hypokalemia caused by a Chinese herbal remedy (Yokukansan) in an 81-year-old woman with dementia]. 2232 35