Davide Tassinari1, Rosalba Bergamaschi2, Ilaria Corsini2, Susanna Landini2, Benedetta Romanin2, Elisa Ballarini2, Fabrizio De Ponti3, Filomena Carfagnini4, Francesco Toni5, Filippo Bernardi2. 1. Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy. Electronic address: davide.tassinari@aosp.bo.it. 2. Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy. 3. Department of Medical and Surgical Sciences, Pharmacology Unit, University of Bologna, Italy. 4. Department of Pediatric Radiology, S. Orsola-Malpighi Hospital of Bologna, Italy. 5. IRCCS Institute of Neurological Sciences, Bologna, Italy.
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.
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.