Posterior Reversible Encephalopathy Syndrome Associated With Licorice Consumption: A Case Report in a 10-Year-Old Boy

• Published in: Pediatric neurology Vol. 52; no. 4; pp. 457 - 459
• Main Authors: Tassinari, Davide, MD, Bergamaschi, Rosalba, MD, Corsini, Ilaria, MD, Landini, Susanna, MD, Romanin, Benedetta, MD, Ballarini, Elisa, MD, De Ponti, Fabrizio, MD, Carfagnini, Filomena, MD, Toni, Francesco, MD, Bernardi, Filippo, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2015
• Subjects: 11β-hydroxysteroid dehydrogenase; Brain - drug effects; Brain - pathology; Child; children; Diet - adverse effects; Follow-Up Studies; Glycyrrhiza - adverse effects; Glycyrrhiza glabra; Glycyrrhizic Acid - adverse effects; Humans; hypertension; Hypertension - pathology; Hypertension - physiopathology; licorice; Magnetic Resonance Imaging; Male; Neurology; Pediatrics; Posterior Leukoencephalopathy Syndrome - pathology; Posterior Leukoencephalopathy Syndrome - physiopathology; PRES; 11β-hydroxysteroid dehydrogenase; licorice; PRES; children; hypertension
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2014.12.001

Abstract Background Posterior reversible encephalopathy syndrome is characterized by a combination of clinical-radiological findings and pathophysiologically by localized brain vasogenic edema. Many clinical illnesses may trigger the onset of posterior reversible encephalopathy syndrome and hypertension is present in about 80% of patients. Methods We describe a child with high consumption of licorice toffees who developed systemic hypertension followed by posterior reversible encephalopathy syndrome. Results This boy was hospitalized following a cluster of generalized tonic-clonic seizures. Monitoring his clinical parameters, we detected constant high blood pressure and a brain magnetic resonance scan showed a localized vasogenic edema; these symptoms suggested posterior reversible encephalopathy syndrome. He had been eating licorice toffees for a period of 4 months, consuming an estimated 72 mg of glycyrrhizic acid per day; this led to our assumption of the reason for his hypertension. Conclusion There are several reported examples of posterior reversible encephalopathy syndrome–induced licorice hypertension in adults, but none related to children. Our report examines a possible link between licorice consumption and hypertension/posterior reversible encephalopathy syndrome in children.