Licorice consumption causing severe hypokalemic paralysis.
Hypokalemic paralysis due to licorice consumption is extremely rare, with only 40 cases in the English literature describing paralysis secondary to exposure to licorice in candies, medications, chewing tobacco, and herbal preparations. We describe a patient who suffered life-threatening hypokalemic paralysis caused by consumption of licorice in the form of a tea sweetener superimposed on long-term consumption of licorice candy. Aggressive fluid and potassium replenishment produced complete and lasting recovery. To our knowledge, this is the first report of hypokalemic paralysis due to exposure to licorice as a tea sweetener, a common custom among the Arab population. The case emphasizes the importance of considering patients' cultural backgrounds and local customs, which often may lead the treating physician to the correct clinical diagnosis.
Elinav
Eran
E
Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Chajek-Shaul
Tova
T
D000328:Adult; D018912:Arabs; D003466:Cultural Characteristics; D003937:Diagnosis, Differential; D006035:Glycyrrhiza / Q000009:adverse effects*; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D007557:Israel; D008297:Male; D010243:Paralysis / Q000139:chemically induced* / Q000188:drug therapy; D017680:Potassium Compounds / Q000008:administration & dosage; D013549:Sweetening Agents / Q000009:adverse effects*
D017680:Potassium Compounds; D013549:Sweetening Agents