A rare cause of thyrotoxic periodic paralysis: liquorice consumption

Sayıner, Zeynel Abidin; Abiyev, Azer; Eraydın, Ayten; Özkaya, Mesut

doi:10.1136/postgradmedj-2016-134716

Cited by 2 publications

(2 citation statements)

References 12 publications

(13 reference statements)

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“…8 Other known triggers include large carbohydrate loads (excess insulin), exercise (excess catecholamines), stress, toxic adenomas, diuretics, fluoroquinolones, aminoglycosides, amiodarone, alcohol, and even licorice. 2,8,9,10 Presentations vary widely from mild, transient, selflimited motor dysfunction to total flaccid paralysis including respiratory muscles. 11,12,13 Bulbar and ocular symptoms have been reported in rare cases; however, it is unclear whether ocular involvement stems from THPP or the thyrotoxicosis.…”

Section: Discussionmentioning

confidence: 99%

Stroke Mimic: A Case of Unilateral Thyrotoxic Hypokalemic Periodic Paralysis

Lajeunesse

Young

2020

Clinical Practice and Cases in Emergency Medicine

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Thyrotoxic hypokalemic periodic paralysis (THPP) is a condition that results in transient skeletal muscle paralysis secondary to intracellular potassium sequestration. Susceptible individuals often have an underlying channelopathy, which may be exacerbated by lifestyle factors or underlying medical comorbidities such as hyperthyroidism or diarrheal illness. Classically, THPP presents with paralysis of proximal extremity musculature. In this case, we present a rare case of unilateral THPP. Such a presentation is relevant to emergency physicians as it mimics a stroke or transient ischemic attack and should be considered on the differential for unilateral neurologic deficits.

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Section: Discussionmentioning

confidence: 99%

Stroke Mimic: A Case of Unilateral Thyrotoxic Hypokalemic Periodic Paralysis

Lajeunesse

Young

2020

Clinical Practice and Cases in Emergency Medicine

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“…In the other cases the unconsciousness was related to major adverse events, i.e., torsade de point [ 59 , 97 , 134 ], cardiac arrest [ 42 , 86 , 88 ], Brugada-like pattern [ 45 ], and ventricular tachycardia [ 99 , 100 ]. Neurological manifestations were quite frequently (27 out of 104) reported, such as flaccid paresis [ 29 , 33 , 40 , 45 , 77 , 84 , 87 , 96 , 101 ] and hypertensive encephalopathy microhemorrhages [ 51 , 83 ].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Liquorice Toxicity: A Comprehensive Narrative Review

Ceccuzzi,

Rapino,

Perna

et al. 2023

Nutrients

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Background: Renowned since ancient times for its medical properties, liquorice is nowadays mainly used for flavoring candies or soft drinks. Continuous intake of large amounts of liquorice is a widely known cause of pseudo-hyperaldosteronism leading to hypertension and hypokalemia. These manifestations are usually mild, although in some cases may generate life-threatening complications, i.e., arrhythmias, muscle paralysis, rhabdomyolysis, and coma. In addition, liquorice has an important estrogenic-like activity. Methods: We summarized the current knowledge about liquorice and reviewed 104 case reports in both the English and Italian languages from inception to June 2023 concerning complications due to an excess of liquorice intake. Results: In contrast to most published data, female sex and old age do not appear to be risk factors. However, hypertension and electrolyte imbalance (mainly hypokalemia) are prevalent features. The detection of glycyrrhetinic acid in blood is very uncommon, and the diagnosis is essentially based on an accurate history taking. Conclusions: Although there is not a significant mortality rate, liquorice toxicity often requires hospitalization and therefore represents a significant health concern. Major pharmaceutical drug regulatory authorities should solicit public awareness about the potentially dangerous effects caused by excessive use of liquorice.

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A rare cause of thyrotoxic periodic paralysis: liquorice consumption

Cited by 2 publications

References 12 publications

Stroke Mimic: A Case of Unilateral Thyrotoxic Hypokalemic Periodic Paralysis

Stroke Mimic: A Case of Unilateral Thyrotoxic Hypokalemic Periodic Paralysis

Liquorice Toxicity: A Comprehensive Narrative Review

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