Ramchandran Roshna, Verma Shivendra, Dasgupta Riddhi, Thomas Nihal
Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.
BMJ Case Rep. 2018 Aug 10;2018:bcr-2018-225686. doi: 10.1136/bcr-2018-225686.
Chronic liquorice ingestion is a rare cause of secondary hypertension and hypokalaemia with periodic paralysis. We report the case of a middle-aged Indian man who presented with hypertension and hypokalaemic alkalosis with recurrent bouts of periodic paralysis. Biochemical investigations revealed suppressed plasma renin and aldosterone concentrations with normal cortisol concentration. A detailed history revealed that he was addicted for the last 5 years to a form of chewing tobacco mixed with herbal preparations as a sweetening agent which on analysis revealed active principles of glycyrrhizin using the thin liquid chromatography method. The hypokalaemia resolved and hypertension control improved significantly after discontinuing liquorice consumption, and the patient was asymptomatic at 1-year follow-up. Long-term liquorice ingestion should be kept in mind as a reversible cause of hypokalaemic periodic paralysis, with a meticulous history and biochemical evaluation helping in identifying this recognisable and curable medical disorder.
长期摄入甘草是继发性高血压、低钾血症伴周期性麻痹的罕见病因。我们报告了一例中年印度男性病例，该患者表现为高血压、低钾性碱中毒，并伴有反复发作的周期性麻痹。生化检查显示血浆肾素和醛固酮浓度降低，皮质醇浓度正常。详细病史显示，他在过去5年中沉迷于一种混合了草药制剂作为甜味剂的咀嚼烟草，经分析，采用薄液色谱法发现其中含有甘草甜素的活性成分。停止食用甘草后，低钾血症得到缓解，高血压控制明显改善，患者在1年随访时无症状。长期摄入甘草应被视为低钾性周期性麻痹的一个可逆转病因，详细的病史和生化评估有助于识别这种可识别且可治愈的医学病症。
