title: [Hypokalemia without arterial hypertension by licorice poisoning].
abstract: We report a case of chronic intoxication with glycyrrhizinic acid, at a dosage of 1000 to 1500 mg per month over a period of 11 months, in a former alcoholic. This intoxication was revealed by profound hypokalaemia and rhabdomyolysis. However, blood pressure remained constantly normal. Analysis of the literature shows that liquorice intoxication, which blocks renal 11 beta-hydroxysteroid dehydrogenase evolves more frequently as isolated hypokalaemia than as a picture of pseudo-primary hyperaldosteronism accompanied with hypertension. Hypokalaemia with urinary potassium wasting and without hypertension should therefore lead to considering liquorice intoxication, which can be confirmed by disclosing shut-off of the renin-angiotensin-aldosterone axis, and by the increase of the urinary ratio of [cortisol metabolites (5 alpha tetrahydrocortisol + 5 beta tetrahydrocortisol)]/[cortisone metabolite (5 beta tetrahydrocortisol)] together with increase of urinary free cortisol excretion.
authors.affiliation: Service de Néphrologie, Hôpital Avicenne, Bobigny.
authors.forename: L
authors.initials: L
authors.lastname: Luchon
authors.forename: A
authors.initials: A
authors.lastname: Meyrier
authors.forename: F
authors.initials: F
authors.lastname: Paillard
mesh_terms: D042842:11-beta-Hydroxysteroid Dehydrogenases; D000328:Adult; D001794:Blood Pressure; D005260:Female; D006034:Glycyrrhetinic Acid / Q000031:analogs & derivatives* / Q000506:poisoning; D006035:Glycyrrhiza; D019695:Glycyrrhizic Acid; D006801:Humans; D006913:Hydroxysteroid Dehydrogenases / Q000037:antagonists & inhibitors; D007008:Hypokalemia / Q000139:chemically induced*; D008901:Mineralocorticoids / Q000378:metabolism; D010946:Plants, Medicinal; D012206:Rhabdomyolysis / Q000139:chemically induced
chemical_list: D008901:Mineralocorticoids; D019695:Glycyrrhizic Acid; D006913:Hydroxysteroid Dehydrogenases; D042842:11-beta-Hydroxysteroid Dehydrogenases; D006034:Glycyrrhetinic Acid
vernacular_title: Hypokaliémie sans hypertension artérielle par intoxication à la réglisse.