Journal of the Korean neurological association (대한신경과학회지)

Korean Neurological Association (대한신경과학회)
권호 표지

A Case of Glycyrrhizin (Licorice)-induced Hypokalemic Myopathy

감초 유발성 저칼륨혈증성 근육병증 1예

Kim, Beom-Joon;Hong, Yoon-Ho;Sung, Jung-Joon;Park, Kyung-Seok;Hyun, Chang-Lim;Choe, Ghee-Young;Park, Seong-Ho;Lee, Kwang-Woo
김범준;홍윤호;성정준;박경석;현창림;최기영;박성호;이광우

  • Published : 20060000
⟨ Previous Next ⟩

Abstract

Glycyrrhizin, the main ingredient of licorice, may evoke severe hypokalemia and muscle paralysis by its mineralocorticoid effects. We present a 78-year-old man who developed subacute flaccid quadriparesis with a high creatine kinase (CK) level, hypokalemia, metabolic alkalosis, and low plasma renin activity after ingesting licorice daily for two years. A muscle biopsy revealed vacuolar degeneration of myofibers. This case suggests that glycyrrhizin (licorice)-induced hypokalemic myopathy must be included in the differential diagnosis of a patient with generalized muscle weakness and hypokalemia. J Korean Neurol Assoc 24(4):389-391, 2006

Keywords

References

  1. Cayley FE. Potassium deficiency in p-aminosalicylic acid therapy: cardiac and paralytic effects. Lancet 1950;1:447-448
  2. Cho S, Lim B, Cho H, Joung J, Choi Y, Kim D, et al. Licorice Induced Hypokalemia. Korean J Nephrol 2001;20:1021-1025
  3. Kim KW, Chung JB, Cho HK, Sunwoo IN, Choi IS, Cho PJ. Clinical study of 35 cases with periodic paralysis. J of Korean Med Assoc 1981;24:903-911
  4. Ahlawat SK, Sachdev A. Hypokalaemic paralysis. Postgrad Med J 1999;75:193-197 https://doi.org/10.1136/pgmj.75.882.193
  5. Zaidat OO, Ruff RL, Kaminski HJ. Endocrine and toxic myopathies. In: Schapira AHV, Griggs RC. Blue books of practical neurology. 24th ed (Muscle diseases). Boston: Butterworth-Heinemann, 1999;363-391
  6. Shintani S, Murase H, Tsukagoshi H, Shiigai T. Glycyrrhizin (Licorice)-induced hypokalemic myopathy. Eur Neurol 1992;32:44-51 https://doi.org/10.1159/000116786
  7. Conn JW, Rovner DR, Cohen EL. Licorice-induced pseudoaldosteronism. Hypertension, hypokalemia, aldosteronopenia, and suppressed plasma rennin activity. JAMA 1968;205:492-496 https://doi.org/10.1001/jama.205.7.492
  8. Ulmann A, Menard J, Corvol P. Binding of glycyrrhetinic acid to kidney mineralocorticoid and glucocorticoid receptors. Endocrinology 1975;97:46-51 https://doi.org/10.1210/endo-97-1-46
  9. Ishikawa S, Saito T. The effect of glycyrrhetinic acid on the action of aldosterone in stimulating sodium transport in frog skin. Endocrinol Jpn 1980;27:697-701 https://doi.org/10.1507/endocrj1954.27.697
  10. Su X, Lawrence H, Ganeshapillai D, Cruttenden A, Purohit A, Reed MJ, et al. 18beta-glycyrrhetinic acid analogues as potent and selective inhibitors of 11beta-hydroxysteroid dehydrogenases. Bioorg Med Chem 2004;12:4439-4457 https://doi.org/10.1016/j.bmc.2004.06.008