Article: [A 87-year-old woman with mineralocorticoid excess due to 11 beta-HSD2 deficiency].
Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
2007 Volume 44, Issue 4, Page(s) 513–516
Abstract: A 87-year-old woman presented with hypertension and motor disturbance in upper and lower extremities due to severe muscle weakness. As she had a history of licorice administration, laboratory data was obtained approximately 3 months after the drug ... ...
Abstract | A 87-year-old woman presented with hypertension and motor disturbance in upper and lower extremities due to severe muscle weakness. As she had a history of licorice administration, laboratory data was obtained approximately 3 months after the drug cessation. She showed hypokalemia (2.7 mEq/l), metabolic alkalosis and reduced plasma renin activity (PRA). Despite the mineralocorticoid excess, plasma aldosterone concentration (PAC) and 24-hour urine aldosterone were markedly diminished (32 pg/ml and 1.1 microg/day, respectively). Thyroid function was normal, and plasma ACTH and serum cortisol levels were within normal limits. Serum potassium levels was elevated (3.9 mEq/l) and blood pressure returned to normal by cortisol suppression with dexamethasone, 1.5mg per day. Moreover, administration of spironolactone, 50-75 mg per day, caused additional elevation of serum potassium level (4.7 mEq/l) with clinical improvement. These results revealed that the mineralocorticoid excess, found in the present patient, was responsible to dexamesathone and spironolactone, suggesting 11 beta-HSD2 deficiency. Serum cortisol/cortisone ratio (0.95) was also elevated, as compared with age-matched female control (0.28-0.72). The active component of licorice, glycyrrhetinic acid, has a mineralocorticoid-like side effect. However, in the present patient, diminution in serum potassium level and PAC were still found approximately 1 year after stopping licorice. Recently, elderly patients with 11 beta-HSD2 deficiency are often reported, therefore further investigations in relation to the changes caused by aging are needed to elucidate this abnormality. |
---|---|
MeSH term(s) | Aged, 80 and over ; Aldosterone/blood ; Female ; Glycyrrhiza/adverse effects ; Humans ; Mineralocorticoid Excess Syndrome, Apparent/diagnosis ; Potassium/blood |
Chemical Substances | Aldosterone (4964P6T9RB) ; Potassium (RWP5GA015D) |
Language | Japanese |
Publishing date | 2007-09-01 |
Publishing country | Japan |
Document type | Case Reports ; English Abstract ; Journal Article |
ZDB-ID | 604107-3 |
ISSN | 0300-9173 |
ISSN | 0300-9173 |
DOI | 10.3143/geriatrics.44.513 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
Zs.A 1039: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.