Hypokalemia with uncontrolled arterial hypertension due to pseudohyperaldosteronism syndrome in association with therapeutic doses of glycyrrhizic acid intake

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Hypokalemia has a wide range of possible causes and is associated with the risk of serious complications. The article presents a rare clinical case of observation of a patient with persistent hypokalemia and uncontrolled arterial hypertension, which developed due to pseudohyperaldosteronism syndrome associated of taking therapeutic doses of glycyrrhizic acid. The presented clinical case illustrates the importance of careful collection of anamnesis, including drug history, in all patients, as well as increased vigilance regarding secondary causes of the development of arterial hypertension and adverse events associated with taking a wide range of different drugs (including those containing glycyrrhizic acid), especially in the elderly and / or patients with liver disease.

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作者简介

Elizaveta Kotova

RUDN University

编辑信件的主要联系方式.
Email: kotova_eo@pfur.ru
ORCID iD: 0000-0002-9643-5089
SPIN 代码: 6397-6480

MD, Dr. Sci. (Medicine), associate professor, associate professor of the Department of internal medicine with a course in cardiology and functional diagnostics named after academician V.S. Moiseyev of the Institute of clinical medicine; cardiologist at V.V. Vinogradov University Clinical Hospital

俄罗斯联邦, 117292, Moscow, 61/1 Vavilova St.

Olga Arisheva

RUDN University

Email: olga.arisheva@yandex.ru
ORCID iD: 0000-0002-2964-0568
SPIN 代码: 7556-0455

MD, PhD (Medicine), associate professor of the Department of internal medicine with a course in cardiology and functional diagnostics named after academician V.S. Moiseyev of the Institute of clinical medicine, V.V. Vinogradov University Clinical Hospital

俄罗斯联邦, 117292, Moscow, 61/1 Vavilova St.

Irina Misan

RUDN University

Email: irina.misan20@gmail.com
ORCID iD: 0000-0002-3223-128X
SPIN 代码: 2273-4624

MD, PhD (Medicine), assistant at the Department of internal medicine with a course in cardiology and functional diagnostics named after academician V.S. Moiseyev of the Institute of clinical medicine; V.V. Vinogradov University Clinical Hospital

俄罗斯联邦, 117292, Moscow, 61/1 Vavilova St.

参考

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2. Fig. 1. Results of 24-hour blood pressure monitoring in the observed patient Note: SBP – systolic blood pressure; DBP – diastolic blood pressure; HR – heart rate; RR – respiratory rate.

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3. Fig. 2. Algorithm for diagnosing hyperaldosteronism [5, 6] Note: AG – arterial hypertension; PHA – primary hyperaldosteronism; A – aldosterone; K – creatinine; PRA – plasma renin activity; CT – computed tomography; AMP – mineralocorticoid receptor antagonists; SSVS – comparative selective venous blood sampling.

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4. Fig. 3. Possible causes of hypokalemia [4] Note: GI – gastrointestinal tract; CBV – circulating blood volume; HF – heart failure.

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5. Fig. 4. Disease progression diagram for the patient under observation. Note: BMI – body mass index; WC – waist circumference; DM – diabetes mellitus; HbA1c – glycated hemoglobin; IVD – intervertebral disc; CCH – city clinical hospital.

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6. Fig. 5. The effect of glycyrrhizic acid on the development of pseudohyperaldosteronism [12, 13]

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