Acute hypokalemic myopathy due to chronic licorice ingestion: report of a case

A 35-year-old man, who had been ingesting one or two bags of tablets of pure licorice daily (20-40 g/day) for about two years, developed an acute myopathy with high levels of serum muscle enzymes and the typical features of mineralocorticoid excess: serious hypokalemia, hypertension, metabolic alkal...

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Bibliographic Details
Published inItalian journal of neurological sciences Vol. 4; no. 4; p. 493
Main Authors Corsi, F M, Galgani, S, Gasparini, C, Giacanelli, M, Piazza, G
Format Journal Article
LanguageEnglish
Published Italy 01.12.1983
Subjects
Adult
Aldosterone - blood
Glycyrrhiza
Humans
Hypokalemia - etiology
Male
Microscopy, Electron
Mitochondria, Muscle - ultrastructure
Muscles - pathology
Plants, Medicinal
Renin - blood
Rhabdomyolysis - etiology
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Summary:A 35-year-old man, who had been ingesting one or two bags of tablets of pure licorice daily (20-40 g/day) for about two years, developed an acute myopathy with high levels of serum muscle enzymes and the typical features of mineralocorticoid excess: serious hypokalemia, hypertension, metabolic alkalosis. Both plasma renin and serum aldosterone were below the normal values. Ultrastructural study of muscle showed only minor, aspecific changes. Glycyrrhizinic acid, a steroid-like glycoside contained in natural licorice, has a well-known mineralocorticoid activity but severe potassium depletion and rhabdomyolysis due to chronic licorice ingestion have rarely been reported. This case further indicates that such a possibility is to be considered in the differential diagnosis of a patient admitted because of acute flaccid tetraparesis and hypokalemia.
ISSN:0392-0461
DOI:10.1007/BF02125633