title: Licorice-induced severe hypokalemia with recurrent torsade de pointes.
abstract: A 38-year-old obese woman presented with recurrent polymorphic ventricular tachycardia secondary to persistent hypokalemia necessitating more than 40 DC shocks. All endocrine investigations for hypokalemia were negative with impression of "mysterious hypokalemia." On repeated inquiry, a hidden history of licorice use was elicited causing persistent hypokalemia. The case highlights a life threatening complication of licorice use. In addition, it reiterates the importance of repeated history taking in a patient with undiagnosed hypokalemia and torsade de pointes which avoided a device therapy.
authors.affiliation: Department of Cardiology, Royal Hospital, Muscat, Oman.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Panduranga
authors.forename: Najib
authors.initials: N
authors.lastname: Al-Rawahi
mesh_terms: D000328:Adult; D004554:Electric Countershock / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006035:Glycyrrhiza / Q000009:adverse effects*; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D008278:Magnesium Sulfate / Q000627:therapeutic use; D011188:Potassium / Q000627:therapeutic use; D012720:Severity of Illness Index; D017180:Tachycardia, Ventricular / Q000139:chemically induced / Q000150:complications / Q000628:therapy; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000150:complications / Q000628:therapy
chemical_list: D008278:Magnesium Sulfate; D011188:Potassium
keywords: hypokalemia; licorice; polymorphic ventricular tachycardia; torsade de pointes