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Hong, Han, Hwang, Kim, Shim, and Kim: A Case of Licorice Induced Hypokalemic Paralysis with Rhabdomyolysis
Case Report
Journal of Korean Society of Endocrinology

Journal of Korean Society of Endocrinology 2005; 20(2): 179-182.

Published online: 20 April 2005

DOI: https://doi.org/10.3803/jkes.2005.20.2.179

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.

Received 18 February 2005       Accepted 10 March 2005

Copyright © 2005 Korean Endocrine Society

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 160/80 mmHg. The major biochemical abnormalities included; hypokalemia (K+ 1.3 mEq/L), metabolic alkalosis, with a pH of 7.64, and urine myoglobin > 3000 ng/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 500 g of licorice boiled in water. After quitting the licorice, the hypokalemia and muscle paralysis gradually improved and blood pressure returned to normal.

Keywords: Licorice, Glycyrrhizic acid, Hypokalemic paralysis, Rhabdomyolysis

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