A Case of Licorice Induced Hypokalemic Paralysis with Rhabdomyolysis.

Hong, Hyun Il; Han, Koon Hee; Hwang, Jung Won; Kim, Young Don; Shim, Myung Sook; Kim, Jin Yub

doi:2005.20.2.179

Endocrinol Metab > Volume 20(2); 2005 > Article

Case Report

Journal of Korean Endocrine Society 2005;20(2):179-182.
DOI: https://doi.org/10.3803/jkes.2005.20.2.179 Published online April 1, 2005.

A Case of Licorice Induced Hypokalemic Paralysis with Rhabdomyolysis.

Hyun Il Hong, Koon Hee Han, Jung Won Hwang, Young Don Kim, Myung Sook Shim, Jin Yub Kim

Department of Internal Medicine, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, Korea.

Abstract

Prolonged ingestion of licorice can cause hypermineralocorticoidism, with sodium retention, potassium loss and hypertension. Nevertheless, its initial presentation with a very severe degree of hypokalemic paralysis and rhabdomyolysis are exceedingly rare. We describe a patient who experienced hypokalemic paralysis and rhabdomyolysis after licorice ingestion. The patient's initial blood pressure was 160/80mmHg. The major biochemical abnormalities included; hypokalemia(K+ 1.3mEq/L), metabolic alkalosis, with a pH of 7.64, and urine myoglobin > 3000ng/mL. The plasma rennin activity and aldosterone level were suppressed. The 24 hour urine cortisol concentration was normal. The patients, over a 1 month period, had ingested 500g of licorice boiled in water. After quitting the licorice, the hypokalemia and muscle paralysis gradually improved and blood pressure returned to normal

Key Words: Licorice, Glycyrrhizic acid, Hypokalemic paralysis, Rhabdomyolysis