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      Licorice‐Induced Severe Hypokalemia with Recurrent Torsade de Pointes

      case-report

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          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.

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          Effect of licorice on the reduction of body fat mass in healthy subjects.

          D. Armanini, Laura M. Palermo, I Karbowiak … (2003)
          The history of licorice, as a medicinal plant, is very old and has been used in many societies throughout the millennia. The active principle, glycyrrhetinic acid, is responsible for sodium retention and hypertension, which is the most common side-effect. We show an effect of licorice in reducing body fat mass. We studied 15 normal-weight subjects (7 males, age 22-26 yr, and 8 females, age 21-26 yr), who consumed for 2 months 3.5 g a day of a commercial preparation of licorice. Body fat mass (BFM, expressed as percentage of total body weight, by skinfold thickness and by bioelectrical impedance analysis, BIA) and extracellular water (ECW, percentage of total body water, by BIA) were measured. Body mass index (BMI) did not change. ECW increased (males: 41.8+/-2.0 before vs 47.0+/-2.3 after, p<0.001; females: 48.2+/-1.4 before vs 49.4+/-2.1 after, p<0.05). BFM was reduced by licorice: (male: before 12.0+/-2.1 vs after 10.8+/-2.9%, p<0.02; female: before 24.9+/-5.1 vs after 22.1+/-5.4, p<0.02); plasma renin activity (PRA) and aldosterone were suppressed. Licorice was able to reduce body fat mass and to suppress aldosterone, without any change in BMI. Since the subjects were consuming the same amount of calories during the study, we suggest that licorice can reduce fat by inhibiting 11beta-hydroxysteroid dehydrogenase Type 1 at the level of fat cells.
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            Too much of a good thing: a woman with hypertension and hypokalemia.

            Sean C. Murphy, Sean Agger, Petrie M Rainey (2009)
            Article 0 comments Cited 10 times – based on 0 reviews     Review now
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              Author and article information

              Journal
              Journal ID (nlm-ta): Ann Noninvasive Electrocardiol
              Journal ID (iso-abbrev): Ann Noninvasive Electrocardiol
              Journal ID (doi): 10.1111/(ISSN)1542-474X
              Journal ID (publisher-id): ANEC
              Title: Annals of Noninvasive Electrocardiology : The Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
              Publisher: John Wiley and Sons Inc. (Hoboken )
              ISSN (Print): 1082-720X
              ISSN (Electronic): 1542-474X
              Publication date (Electronic): 09 September 2013
              Publication date Collection: November 2013
              Volume: 18
              Issue: 6 ( doiID: 10.1002/anec.2013.18.issue-6 )
              Pages: 593-596
              Affiliations
              [ 1 ] Department of Cardiology Royal Hospital Muscat Oman
              Author notes
              [*] [* ]Address for correspondence: Dr. Prashanth Panduranga, M.R.C.P., Department of Cardiology, Royal Hospital, Post Box 1331, Muscat‐111, Sultanate of Oman. E‐mail: prashanthp_69@ 123456yahoo.co.in
              Article
              Accession ID: PMC6932213 Pmcid ID: PMC6932213 Pmc-uid ID: 6932213 Publisher ID: ANEC12076
              DOI: 10.1111/anec.12076
              PMC ID: 6932213
              PubMed ID: 24303973
              SO-VID: 551b76aa-b95e-4da6-bd55-0f7fe4009c72
              Copyright © ©2013 Wiley Periodicals, Inc.
              History
              Page count
              Pages: 4
              Categories
              Subject: Case Report
              Subject: Case Reports
              Custom metadata
              source-schema-version-number 2.0
              cover-date November 2013
              details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.3 mode:remove_FC converted:18.12.2019

              Keywords: hypokalemia,licorice,torsade de pointes,polymorphic ventricular tachycardia
              Data availability:
              Keywords: hypokalemia, licorice, torsade de pointes, polymorphic ventricular tachycardia

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