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BMJ Case Reports 2017; doi:10.1136/bcr-2017-222077
  • Reminder of important clinical lesson
  • CASE REPORT

All sorts of tests, only one question: an unexpected cause of hypertension

  1. Soon Song
  1. Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  1. Correspondence to Dr Sarah Foster, slfoster{at}doctors.org.uk
  • Accepted 30 October 2017
  • Published 9 November 2017

Summary

A 48-year-old woman presented to the Accident and Emergency department with a 4 month history of headaches, nausea and dizziness. She was found to have severe hypertension and hypokalaemia. Extensive investigations did not find any secondary cause for hypertension. The patient was discharged with oral doxazosin therapy which controlled the blood pressure. Before the follow-up appointment at the hypertension clinic, the patient and her husband identified that her headaches coincided with liquorice tea consumption of up to three cups per day. This information was not obtained in the clinical assessment. The patient is now headache and medication free after cessation of liquorice tea. Liquorice ingestion is often a forgotten reversible cause of hypertension. A good history is key to this diagnosis.

Footnotes

  • Contributors SF wrote the main body of the text as the junior doctor. RF, PJ and SS were supervising consultants involved with the patient’s care from an acute medicine and medical physician perspective as well as being involved with follow-up. RF and SS reviewed and edited the case report.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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