Pseudoaldosteronism complicated with hypokalemic rhabdomyolysis induced by long-term use of oral glycyrrhizic acid preparations
10.3760/cma.j.cn114015-20210222-00194
- VernacularTitle:长期口服甘草酸制剂致假性醛固酮增多症合并低钾性横纹肌溶解
- Author:
Xue SUN
1
;
Hua ZENG
;
Zhuoga CIDAN
;
Wei ZUO
;
Zhuoga CIDAN
Author Information
1. 西藏自治区人民医院药学部，拉萨 850000
- Publication Type:Journal Article
- Keywords:
Glycyrrhizic acid;
Hypokalemia;
Rhabdomyolysis
- From:
Adverse Drug Reactions Journal
2021;23(11):609-611
- CountryChina
- Language:Chinese
-
Abstract:
A 50-year-old female patient was treated with diammonium glycyrrhizinate enteric-coated capsules for about 22 months irregularly due to repeated abnormal liver function, which was changed to compound glycyrrhizin 3 tablets thrice daily later. After 4 months of treatment with compound glycyrrhizin, the patient developed myalgia with fatigue and the symptoms gradually aggravated, resulting in weakness of limbs and difficulty in walking. Compound glycyrrhizin were stopped for 1 week, but the symptoms were not improved, with a blood pressure of 160/100 mmHg. Laboratory tests showed blood potassium 1.9 mmol/L, alanine aminotransferase (ALT) 54 U/L, aspartate aminotransferase (AST) 104 U/L, creatine kinase (CK) >2 200 U/L, myoglobin 542.1 μg/L, and blood pH 7.56. Intravenous and oral potassium supplementation and symptomatic treatments were given. Three days later, the symptoms of myalgia and fatigue were markedly improved and the blood potassium returned to 3.5 mmol/L. Two weeks later, the patient′s muscle strength recovered and the blood pressure was 100/71 mmHg. Laboratory tests showed blood potassium 4.2 mmol/L, ALT 45 U/L, AST 38 U/L, and CK 44 U/L. Aldosterone postural stimulation test and captopril challenge test were performed for definite diagnosis, showing normal aldosterone level and decreased renin concentration. Pseudoaldosteronism complicated with hypokalemic rhabdomyolysis was diagnosed, which was considered to be related to long-term administration of glycyrrhizic acid preparations.
