Liquorice-Induced Hypokalaemia and Rhabdomyolysis

Abstract

This is a case report of a 60-year-old man who was admitted at the emergency department with tetra paresis, severe hypokalaemia, rhabdomyolysis and hypertension. The cause could have been hyperaldosteronism, but was found to be liquorice intoxication. Liquorice is both available and widely used in both the confectionary and medical sectors. It has glucocorticoid and mineralocorticoid properties, but can, if consuming too much, lead to an acquired form of apparent mineralocorticoid excess syndrome which causes hypokalaemia, hypernatremia, oedema, hypertension, metabolic alkalosis and low plasma renin and aldosterone levels. In this case, the patient developed rhabdomyolysis because of his hypokalaemia. It is believed that potassium depletion causes ischemia in the muscle cells and it therefore can lead to muscle cramps and necrosis.