Hypertonus und Hypokaliämie - Der Verdacht einer Lakritz-induzierten Hypertonie entpuppt sich als Reninom

HISTORY AND CLINICAL FINDINGS: A 28-year-old woman presented with dizziness and arterial hypertension. She reported a daily intake of 300 mg liquorice.

INVESTIGATIONS: Laboratory analysis revealed hypokalaemia of 2.5 mmol/l and an elevated serum renin activity of 18.6 µg/l/h. Abdominal ultrasound and magnetic resonance imaging showed a circumscribed non-homogenuous round lesion (18 × 22 mm) in the upper third of the right kidney. Selective catheterization of the renal veins revealed increased renin activity in blood from the right renal vein, suggestive of a renin-producing tumor.

TREATMENT AND COURSE: Initially antihypertensive therapy with the direct renin receptor antagonist aliskiren was started and followed by a partial nephrectomy, which brought about adequate blood pressure and potassium levels.

CONCLUSION: The constellation of hypokalaemia and hypertension often leads to important causes of secondary hypertension such as primary hyperaldosteronism or renal artery stenosis. But less frequent causes should also be considered in the differential diagnoses, such as liquorice overindulgence or reninoma.