title: Posterior reversible encephalopathy syndrome associated with licorice consumption: a case report in a 10-year-old boy.
abstract: 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.
  
  
  
  We describe a child with high consumption of licorice toffees who developed systemic hypertension followed by posterior reversible encephalopathy syndrome.
  
  
  
  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.
  
  
  
  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.
authors: Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy. Electronic address: davide.tassinari@aosp.bo.it.
authors: Davide
authors: D
authors: Tassinari
authors: Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
authors: Rosalba
authors: R
authors: Bergamaschi
authors: Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
authors: Ilaria
authors: I
authors: Corsini
authors: Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
authors: Susanna
authors: S
authors: Landini
authors: Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
authors: Benedetta
authors: B
authors: Romanin
authors: Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
authors: Elisa
authors: E
authors: Ballarini
authors: Department of Medical and Surgical Sciences, Pharmacology Unit, University of Bologna, Italy.
authors: Fabrizio
authors: F
authors: De Ponti
authors: Department of Pediatric Radiology, S. Orsola-Malpighi Hospital of Bologna, Italy.
authors: Filomena
authors: F
authors: Carfagnini
authors: IRCCS Institute of Neurological Sciences, Bologna, Italy.
authors: Francesco
authors: F
authors: Toni
authors: Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
authors: Filippo
authors: F
authors: Bernardi
mesh_terms: D001921:Brain / Q000187:drug effects / Q000473:pathology; D002648:Child; D004032:Diet / Q000009:adverse effects; D005500:Follow-Up Studies; D006035:Glycyrrhiza / Q000009:adverse effects*; D019695:Glycyrrhizic Acid / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D054038:Posterior Leukoencephalopathy Syndrome / Q000473:pathology / Q000503:physiopathology*
chemical_list: D019695:Glycyrrhizic Acid
keywords: 11β-hydroxysteroid dehydrogenase; PRES; children; hypertension; licorice