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KMID : 1013220230210020151
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Jouranl of the Korean Society of Clinical Toxicology
2023 Volume.21 No. 2 p.151 ~ p.155
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A case of chronic licorice intoxication-induced apparent mineralocorticoid excess syndrome
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Lim Young-Jae
Kim Ji-Eun
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Abstract
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Licorice is a perennial herb belonging to the legume family that mainly grows in northeastern China,Mongolia, Siberia, and other regions. It is used in traditional medicine in the form of dried roots in theEast and the West. The main active component of licorice, glycyrrhizin, is known to produce mineralocor ticoid effects when consumed chronically, which can lead to apparent mineralocorticoid excess syn drome. Herein, we present the case of a 72-year-old woman who was admitted to the emergency roomwith severe generalized weakness and difficulty keeping her neck upright, which had developed after dai ly consumption of licorice-infused water for the past 2 months. Blood tests revealed metabolic alkalosisand severe hypokalemia, and an electrocardiogram showed ventricular bigeminy. The patient was treatedwith daily potassium and spironolactone supplements, leading to a significant improvement in musclestrength after a week. One week later, the patient was discharged, showing rare ventricular prematurecontractions on electrocardiography, but with no specific complaints. Chronic licorice ingestion leadingto hypokalemia and muscle weakness can be life-threatening, necessitating the discontinuation of thecausative agent, close monitoring, and cautious supplementation of potassium and spironolactone astreatment.
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KEYWORD
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Glycyrrhiza, Liddle syndrome, Apparent mineralocorticoid excess syndrome, Hypokalemic pa ralysis, Case report
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