pseudohyperaldosteronism


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pseudohyperaldosteronism

Liddle syndrome An AD aldosteronism-like condition characterized by severe HTN and spontaneous hypokalemia
(K+ wasting) leading to hypokalemic alkalosis with ↓ aldosterone secretion Treatment KCl, amiloride and triamterene to prevent K+ wasting, sodium restriction; renal transplantation. Cf Hyperaldosteronism.
References in periodicals archive ?
* Pseudohyperaldosteronism caused by liquorice consumption is reversible and generally resolves upon cessation of liquorice consumption.
Lethal liquorice lollies (liquorice abuse causing pseudohyperaldosteronism).
Loss by kidney: (1) diseases related to mineralocorticoid increases mainly include adrenocortical tumor or hyperplasia, juxtaglomerular cell tumor, ectopic aldosterone-producing tumor, Cushing syndrome, and pseudohyperaldosteronism. Patients with these conditions mainly present increased blood pressure.
Pseudohyperaldosteronism and Pseudohypoaldosteronism and the Paediatric Brain.
Type of potassium Imbalance Cause Drugs (tocolytics, theophylline toxicity, chloroquine toxicity, insulin overdose) Transcellular shift Thyrotoxic periodic paralysis Familial periodic paralysis Sporadic periodic paralysis Barium poisoning Drugs: diuretics Primary hyperaldosteronism Renal loss Pseudohyperaldosteronism: licorice ingestion of potassium Bartter's syndrome, Gitelman's syndrome Renal tubular acidosis Other: nephrotic syndrome, acute tubular necrosis, diabetic ketoacidosis, and ureterosigmoidostomy.
Pseudohyperaldosteronism can be caused by overconsumption of Glycyrrhiza glabra (licorice) because glycyrrhizin inhibits 11-beta hydroxysteroid dehydrogenase thus preventing Cortisol's inactivation to cortisone in the kidney and thereby potentiating the mineralocoricoid effect of endogenous Cortisol.
Pseudohyperaldosteronism presents with low aldosterone and low renin and may result from genetic or acquired etiologies.
However, there exists a sensitive subset of the population who appears to show signs of pseudohyperaldosteronism at lower exposures than those which produce effects in the general population.
Promoted as expectorant and digestive aid, licorice is a potent inhibitor of an enzyme in corticosteroid metabolism, so a pseudohyperaldosteronism can result after 4 or more weeks of use.
This results in pseudohyperaldosteronism with sodium and fluid retention, metabolic alkalosis, inhibition of the renin-angiotensin system, and hypertension.
This results in pseudohyperaldosteronism, with sodium and fluid retention, metabolic alkalosis, inhibition of the reninangiotensin system--and hypertension.
Mutations in the genes coding for the [beta] and [gamma] subunits of ENaC have been implicated in Liddle syndrome (pseudohyperaldosteronism), an autosomal-dominantly inherited single-gene disorder in which increased reabsorption of sodium and water in the renal tubule leads to hypertension (12).

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