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Pediatr Neurol. 2015 Apr;52(4):457-9. doi: 10.1016/j.pediatrneurol.2014.12.001. Epub 2014 Dec 11.

Posterior reversible encephalopathy syndrome associated with licorice consumption: a case report in a 10-year-old boy.

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Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy. Electronic address:
Department of Pediatric Emergency, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
Department of Medical and Surgical Sciences, Pharmacology Unit, University of Bologna, Italy.
Department of Pediatric Radiology, S. Orsola-Malpighi Hospital of Bologna, Italy.
IRCCS Institute of Neurological Sciences, Bologna, Italy.



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.


11β-hydroxysteroid dehydrogenase; PRES; children; hypertension; licorice

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