PDF(Pubmed)
Abstract：
UNASSIGNED: Excessive liquorice ingestion sometimes causes pseudoaldosteronism. The association between liquorice-induced pseudoaldosteronism and acute heart failure has not been well described.
UNASSIGNED: An 89-year-old woman was referred to the hospital due to muscle weakness with rhabdomyolysis and severe hypokalaemia. The electrocardiogram in the emergency department revealed pulseless ventricular tachycardia, thus, emergent defibrillation was delivered. Laboratory findings revealed severe hypokalaemia with metabolic alkalosis. Plasma renin activity and serum aldosterone were highly suppressed. Her medications included herbal medicines containing a great amount of liquorice. The patient was diagnosed with pseudoaldosteronism caused by liquorice over-ingestion. She developed acute pulmonary oedema with unexpected left ventricular (LV) dysfunction after the peak out of creatine kinase. She was managed with acute heart failure therapy, as well as optimal medical therapy. She accidentally developed an acute embolic stroke but fully recovered due to emergent thrombolytic therapy. Cardiac magnetic resonance imaging revealed banding late gadolinium enhancement in the basal-mid segments, which was inconsistent with takotsubo cardiomyopathy. As time passed, LV function unexpectedly improved, and congestive heart failure was completely compensated.
UNASSIGNED: Liquorice contains glycyrrhetinic acid that inhibits 11βHSD2. This invites the over-activation of mineralocorticoid receptors by cortisol in the kidneys and eventually causes hypokalaemia and hypertension. Acute heart failure caused by excessive liquorice ingestion is scarcely described. The triggering factors for LV dysfunction and acute congestive heart failure remain unclear. Rhabdomyolysis could affect massive catecholamine release and cause LV dysfunction.
UNASSIGNED: An 89-year-old woman was referred to the hospital due to muscle weakness with rhabdomyolysis and severe hypokalaemia. The electrocardiogram in the emergency department revealed pulseless ventricular tachycardia, thus, emergent defibrillation was delivered. Laboratory findings revealed severe hypokalaemia with metabolic alkalosis. Plasma renin activity and serum aldosterone were highly suppressed. Her medications included herbal medicines containing a great amount of liquorice. The patient was diagnosed with pseudoaldosteronism caused by liquorice over-ingestion. She developed acute pulmonary oedema with unexpected left ventricular (LV) dysfunction after the peak out of creatine kinase. She was managed with acute heart failure therapy, as well as optimal medical therapy. She accidentally developed an acute embolic stroke but fully recovered due to emergent thrombolytic therapy. Cardiac magnetic resonance imaging revealed banding late gadolinium enhancement in the basal-mid segments, which was inconsistent with takotsubo cardiomyopathy. As time passed, LV function unexpectedly improved, and congestive heart failure was completely compensated.
UNASSIGNED: Liquorice contains glycyrrhetinic acid that inhibits 11βHSD2. This invites the over-activation of mineralocorticoid receptors by cortisol in the kidneys and eventually causes hypokalaemia and hypertension. Acute heart failure caused by excessive liquorice ingestion is scarcely described. The triggering factors for LV dysfunction and acute congestive heart failure remain unclear. Rhabdomyolysis could affect massive catecholamine release and cause LV dysfunction.
摘要：
■过量摄入甘草有时会导致假醛固酮增多症。甘草诱导的假醛固酮增多症与急性心力衰竭之间的关系尚未得到很好的描述。
一名89岁的妇女因伴有横纹肌溶解和严重低钾血症的肌肉无力而被转诊到医院。急诊科的心电图显示无脉性室性心动过速,因此，紧急除颤。实验室检查结果显示严重的低钾血症伴代谢性碱中毒。血浆肾素活性和血清醛固酮受到高度抑制。她的药物包括含有大量甘草的草药。患者被诊断为由甘草过量摄入引起的假醛固酮增多症。肌酸激酶达到峰值后，她出现了急性肺水肿，并伴有意外的左心室（LV）功能障碍。她接受了急性心力衰竭治疗，以及最佳的药物治疗。她偶然出现了急性栓塞性中风，但由于紧急溶栓治疗而完全康复。心脏磁共振成像显示，基底中段的钆增强后期，这与takotsubo心肌病不一致。随着时间的流逝,LV功能意外改善，充血性心力衰竭得到了完全补偿。
■甘草含有抑制11βHSD2的甘草次酸。这会导致肾脏中皮质醇过度激活盐皮质激素受体，并最终导致低钾血症和高血压。几乎没有描述过量摄入甘草引起的急性心力衰竭。LV功能障碍和急性充血性心力衰竭的触发因素仍不清楚。横纹肌溶解可影响儿茶酚胺的大量释放并引起LV功能障碍。
一名89岁的妇女因伴有横纹肌溶解和严重低钾血症的肌肉无力而被转诊到医院。急诊科的心电图显示无脉性室性心动过速,因此，紧急除颤。实验室检查结果显示严重的低钾血症伴代谢性碱中毒。血浆肾素活性和血清醛固酮受到高度抑制。她的药物包括含有大量甘草的草药。患者被诊断为由甘草过量摄入引起的假醛固酮增多症。肌酸激酶达到峰值后，她出现了急性肺水肿，并伴有意外的左心室（LV）功能障碍。她接受了急性心力衰竭治疗，以及最佳的药物治疗。她偶然出现了急性栓塞性中风，但由于紧急溶栓治疗而完全康复。心脏磁共振成像显示，基底中段的钆增强后期，这与takotsubo心肌病不一致。随着时间的流逝,LV功能意外改善，充血性心力衰竭得到了完全补偿。
■甘草含有抑制11βHSD2的甘草次酸。这会导致肾脏中皮质醇过度激活盐皮质激素受体，并最终导致低钾血症和高血压。几乎没有描述过量摄入甘草引起的急性心力衰竭。LV功能障碍和急性充血性心力衰竭的触发因素仍不清楚。横纹肌溶解可影响儿茶酚胺的大量释放并引起LV功能障碍。
