Tetraparesis with Major Hypokalaemia and Rhabdomyolysis Induced by Chronic Liquorice Ingestion
  • Hassene Attout
    Internal Medicine Unit, General Hospital, Ales, France
  • Andry Randriajohany
    Internal Medicine Unit, GHER, Saint-Benoit, Réunion
  • Françoise Josse
    Internal Medicine Unit, GHER, Saint-Benoit, Réunion
  • Vincent Appavoupoule
    Internal Medicine Unit, GHER, Saint-Benoit, Réunion
  • Yoga Thirapathi
    Internal Medicine Unit, GHER, Saint-Benoit, Réunion

Keywords

Hypokalaemia, rhabdomyolysis, liquorice abuse

Abstract

Chronic ingestion of liquorice induces a syndrome with findings similar to those for primary hyperaldosteronism. This is characterized by hypokalaemia, hypertension, metabolic alkalosis and suppression of the renin-aldosterone system.
We describe a 30-year-old woman who, with a plasma potassium level of 1.5 mmol/l, presented with tetraparesis and severe rhabdomyolysis (CK up to 35,460 U/l). She admitted to a daily consumption of nearly 300 g of liquorice sweets during the previous 6 months. This case emphasizes the importance of a detailed anamnesis, which is essential for diagnosis, avoids unnecessary and expensive investigations and reduces the duration of hospitalization.

VIEW THE ENTIRE ARTICLE

References

  • Revers FE. Heeft succus liquiritae een genezende werking op de maagzweer? Ned Tijdschr Geneeskd 1946;90:135–137.

  • Ksano E. How to diagnose and treat a licorice-induced syndrome. Inter Med 2004; 1(43):5–6.

  • De Klerk GJ, Nieuwenhuis MG, Beutler JJ. Hypokalaemia and hypertension with use of licorice flavoured chewing gum. BMJ 1997;314:731–732.

  • Shah M, Williams C, Aggarwal A, Choudrhy WM. Licorice-related rhabdomyolysis: a big price for a sweet tooth. Clin Nephrol 2012;77(6):491–495.

  • Russo S, Mastropasqua M, Mosetti MA, Persegani C, Paggi A. low doses of licorice can induce hypertension encephalopathy. Am J Nephrol 2000:20(2):145–148.

  • Yasue H, Itoh T, Mizuno Y, Harada E. Severe hypokalemia, rhabdomyolysis, muscle paralysis, and respiratory impairment in a hypertensive patient taking herbal medicines containing licorice. Inter Med 2007;46(9):575–578.

  • Miettinen HE, Piippo K, Hannila-Handelberg T, Paukku K, Hiltunen T, Gautschi I, et al. Licorice-induced hypertension and common variants of genes regulating renal sodium reabsorption. Ann Med 2010;42:465–474.
  • Views: 982
    HTML downloads: 69
    PDF downloads: 364


    Published: 2020-03-09
    Issue: 2020: Vol 7 No 4 (view)


    How to cite:
    1.
    Attout H, Randriajohany A, Josse F, Appavoupoule V, Thirapathi Y. Tetraparesis with Major Hypokalaemia and Rhabdomyolysis Induced by Chronic Liquorice Ingestion. EJCRIM 2020;7 doi:10.12890/2020_001375.