Pseudoaldosteronism induced by Yokukansan in an elderly Japanese type 2 diabetic patient with Alzheimer's disease.
Pseudoaldosteronism induced by Yokukansan in an elderly Japanese type 2 diabetic patient with Alzheimer's disease.
复制标题
DOI：
10.1111/jdi.12297
复制
发表时间：
2015-07
影响因子：
3.2
通讯作者：
Kaku K
中科院分区：
文献类型：
--
作者：
Kamei S;Kaneto H;Irie S;Kinoshita T;Tanabe A;Hirukawa H;Tatsumi F;Shimoda M;Kohara K;Mune T;Kaku K
阿尔茨海默病(AD)和/或痴呆的行为和心理症状(BPSD)的患者数量在全球范围内显著增加，已成为一个社会和健康问题。此外，最近已证实糖尿病是发展为痴呆症的主要危险因素1。第二代抗精神病药物已经被使用，但有些病例是难治的。Yokukansan是一种含有甘草的中药，经常被用来治疗这种疾病。先前的一份报告显示，横断散具有有益的效果，可以非常安全地使用。众所周知，大量的甘草可以诱发假性醛固酮增多症，但横断散中只含有少量的甘草。因此，一直认为使用横断散并不会导致假性醛固酮增多症的发病。然而，我们在这里报告一个假性醛固酮增多症的病例，在使用横断散后发展为患有AD和BPSD的日本老年糖尿病患者。2013年2月，一名77岁的日本2型糖尿病男子因低钾血症和体重增加住进了日本仓城县川崎医学院。他已经服用横断散5个月(每天7.5克，含1.5克甘草)。他经常感到全身疲劳，体重增加了7公斤。入院时，他的体重为64.3千克，身高160.5厘米。他没有呕吐或腹泻，也没有使用任何利尿剂。体格检查显示轻度收缩期高血压。双侧下肢有明显的胫前凹陷性水肿。表1显示了入院时的实验室检查结果。
The number of patients with Alzheimer’s disease (AD), and/or behavioral and psychological symptoms of dementia (BPSD) has been markedly increasing all over the world, and has become a social and health problem. Furthermore, it has been recently established that the diabetic condition is a major risk factor for the development of dementia1. Second-generation antipsychotics have been used, but some cases are refractory2. Yokukansan is a licorice-containing Chinese medicine, and has been very often used for the treatment of such disease3. A previous report showed that Yokukansan exerts beneficial effects and can be used very safely3. It is known that a large amount of licorice could induce pseudoaldosteronism, but Yokukansan contains only a small amount of licorice. Therefore, it has been thought that the use of Yokukansan does not lead to the onset of pseudoaldosteronism. However, here we report a case of pseudaldosteronism that developed after starting Yokukansan in an elderly Japanese diabetic patient with AD and BPSD. In February 2013, a 77-year-old Japanese man with type 2 diabetes was admitted to the Kawasaki Medical School, Kurashiki, Japan, because of hypokalemia and weight gain. He had been taking Yokukansan for 5 months (7.5 g/day containing 1.5 g of licorice). He frequently felt general fatigue, and his bodyweight was increased by 7 kg. On admission, his bodyweight was 64.3 kg and height 160.5 cm. He did not have vomiting or diarrhea and did not use any diuretics. Physical examination revealed mild systolic hypertension. Marked pretibial pitting edema was observed in the bilateral lower extremities. Table 1 shows the laboratory findings on admission.