A Case of Licorice-Induced Hypokalemic Rhabdomyolysis in a Patient Using a Diuretic Drug.
- Author:
Kyong Ah PARK
1
;
Soo Jin SEOK
;
Su Ji KIM
;
Hyo Wook GIL
;
Jong Oh YANG
;
Eun Young LEE
;
Sae Yong HONG
Author Information
1. Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. hwgil@schca.ac.kr
- Publication Type:Case Report
- Keywords:
Glycyrrhizic acid;
Hypokalemia;
Rhabdomyolysis
- MeSH:
11-beta-Hydroxysteroid Dehydrogenases;
Aldosterone;
Diarrhea;
Diuretics;
Glycyrrhiza;
Glycyrrhizic Acid;
Heart Failure;
Humans;
Hypertension;
Hypokalemia;
Indapamide;
Losartan;
Male;
Middle Aged;
Muscle Weakness;
Potassium;
Renin;
Rhabdomyolysis
- From:Korean Journal of Medicine
2011;80(Suppl 2):S258-S262
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Glycyrrhizic acid is a component of licorice. It can cause hypokalemia through the inhibition of 11beta-hydroxysteroid dehydrogenase. The severity of symptoms depends on the dose and duration of licorice intake, as well as the individual susceptibility. The safe dose of licorice is 10 mg per day. Even a small amount of licorice can cause side effects, including hypokalemia in patients taking diuretics, with diarrhea, or congestive heart failure. We experienced a 59-year-old male with muscle weakness. He had ingested losartan and indapamide due to hypertension. At presentation, he had ingested 8 mg of licorice daily for the previous 17 days. The patient presented with severe hypokalemia (1.8 mEq/L) and rhabdomyolysis. His renin activity was 0.44 ng/mL/h, and his aldosterone level was 6.0 pg/mL. After cessation of licorice and indapamide, his potassium level recovered. In conclusion, even a small amount of licorice can induce hypokalemia in patients who are taking diuretics.
