3.一位35歲女性，因為最近血壓升高來就診。生化初步檢查都在正常值範圍內，除了血清鉀離子是2.5 mmol/L。 下列那一個診斷最不可能考慮？
(A)單側腎動脈狹窄（unilateral renal arterial stenosis）
(B)服用甘草（licorice）
(C)高登症候群（Gordon’s syndrome）
(D)原發性皮質醛酮症（primary aldosteronism）

Licorice-Induced Hypermineralocorticoidism (NEJM original article)

EXCESSIVE ingestion of licorice may result in sodium and water retention, hypertension, hypokalemia, and suppression of the renin-aldosterone system. 

licorice acts by inhibiting Cortisol oxidase, a component of the widely distributed 11β-hydroxysteroid dehydrogenase system that converts Cortisol to cortisone, producing a state of apparent mineralocorticoid excess similar to that in children with 11/3-hydroxysteroid dehydrogenase deficiency5

In vitro, cortisol has the same binding affinity for mineralocorticoid receptors as aldosterone, whereas that of cortisone is much less. Licorice, by inhibiting 11β-hydroxysteroid dehydrogenase in aldosterone-responsive tissues such as the kidney, where it is found in high concentrations, produces high renal levels of cortisol, which then binds to and activates mineralocorticoid receptors.