title: Acute hypokalemic myopathy due to chronic licorice ingestion: report of a case.
abstract: 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.
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood; D006035:Glycyrrhiza; D006801:Humans; D007008:Hypokalemia / Q000209:etiology*; D008297:Male; D008854:Microscopy, Electron; D008931:Mitochondria, Muscle / Q000648:ultrastructure; D009132:Muscles / Q000473:pathology; D010946:Plants, Medicinal; D012083:Renin / Q000097:blood; D012206:Rhabdomyolysis / Q000209:etiology*
chemical_list: D000450:Aldosterone; D012083:Renin