Low-dose liquorice ingestion resulting in severe hypokalaemic paraparesis, rhabdomyolysis and nephrogenic diabetes insipidus

Putter, Robin De; Donck, J

doi:10.1093/ckj/sft159

Cited by 10 publications

(5 citation statements)

References 15 publications

(14 reference statements)

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“…Although glycyrrhizic is widely recognized, it still has some limitations. Some researchers observed that glycyrrhizin maybe has side effects, including asthenia and muscle cramps (De Putter and Donck, 2014). A brief illustration of the different terpenoid phytochemicals is presented in Figure 3.…”

Section: Terpenoidsmentioning

confidence: 99%

Natural Anti-Inflammatory Compounds as Drug Candidates for Inflammatory Bowel Disease

et al. 2021

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Inflammatory bowel disease (IBD) represents chronic recurrent intestinal inflammation resulting from various factors. Crohn’s disease (CD) and ulcerative colitis (UC) have been identified as the two major types of IBD. Currently, most of the drugs for IBD used commonly in the clinic have adverse reactions, and only a few drugs present long-lasting treatment effects. Moreover, issues of drug resistance and disease recurrence are frequent and difficult to resolve. Together, these issues cause difficulties in treating patients with IBD. Therefore, the development of novel therapeutic agents for the prevention and treatment of IBD is of significance. In this context, research on natural compounds exhibiting anti-inflammatory activity could be a novel approach to developing effective therapeutic strategies for IBD. Phytochemicals such as astragalus polysaccharide (APS), quercetin, limonin, ginsenoside Rd, luteolin, kaempferol, and icariin are reported to be effective in IBD treatment. In brief, natural compounds with anti-inflammatory activities are considered important candidate drugs for IBD treatment. The present review discusses the potential of certain natural compounds and their synthetic derivatives in the prevention and treatment of IBD.

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Section: Terpenoidsmentioning

confidence: 99%

Natural Anti-Inflammatory Compounds as Drug Candidates for Inflammatory Bowel Disease

et al. 2021

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“…In one case, carpal tunnel syndrome was reported that has been attributed to the salt and water retention and edema accompanied with licorice consumption (Tacconi et al ., ). Asthenia and muscle cramps (De Putter and Donck, ), occupational asthma (Cartier et al ., ), and contact allergy (O'Connell et al ., ) are the other recorded licorice‐induced complications (Fig. ).…”

Section: Licorice and Glycyrrhizin‐related Side Effectsmentioning

confidence: 99%

Toxicological Effects of Glycyrrhiza glabra (Licorice): A Review

Nazari

Rameshrad

Hosseinzadeh

2017

Phytotherapy Research

200

137

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Licorice (Glycyrrhiza glabra) has been considered as an herbal drug since ancient time. Nowadays, it is a well-known spice that possesses worth pharmacological effects. However, some relevant articles have revealed negative impacts of licorice in health. By considering the great wishes in using herbal medicine, it is important to show adverse effects of herbal medicine in health. At present, there are misunderstandings toward the safety of herbal medicines. Herein, we gathered scientific research projects on the toxicity effects of licorice and glycyrrhizin to highlight their safety. In this regards, we categorized our findings about the toxicity effects of licorice and glycyrrhizin in acute, sub-acute, sub-chronic, and chronic states. Besides, we discussed on the cytotoxicity, genotoxicity, mutagenicity, and carcinogenicity of licorice and glycyrrhizin as well as their developmental toxicity. This review disclosed that G. glabra and glycyrrhizin salts are moderately toxic. They need to be used with caution during pregnancy. G. glabra and glycyrrhizin possess selective cytotoxic effects on cancerous cells. The most important side effects of licorice and glycyrrhizin are hypertension and hypokalemic-induced secondary disorders. Licorice side effects are increased by hypokalemia, prolonged gastrointestinal transient time, decreased type 2 11-beta-hydroxysteroid dehydrogenase activities, hypertension, anorexia nervosa, old age, and female sex. Copyright © 2017 John Wiley & Sons, Ltd.

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“…Liquorice is the root of Glycyrrhiza glabra and is mostly recognized as a flavoring agent. It has also been used in herbal medicine and even in anti-inflammatory, antiviral, antimicrobial, antioxidative, hepatoprotective, and cardioprotective properties[5]. Glycyrrhizic acid or its hydrolytic product, glycyrrhetinic acid, is found in liquorice extracts and has a well-known mineralcorticoid activity, inhibiting 11 beta-hydroxysteroid dehydrogenase type 2, the enzyme that converts cortisol to cortisone[4].…”

Section: Discussionmentioning

confidence: 99%

Liquorice-induced severe hypokalemic rhabdomyolysis with Gitelman syndrome and diabetes: A case report

Yang¹,

Yin²,

Yang³

et al. 2019

WJCC

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BACKGROUND Licorice-induced severe hypokalemic rhabdomyolysis is clinically rare. Gitelman syndrome (GS) is the most common inherited renal tubular disease, while diabetes is one of the most prevalent diseases in the world. Recently, some studies have found that GS patients had higher diabetic morbidity. However, the coexistence of these three diseases has yet to be reported. CASE SUMMARY We report the case of a 62-year-old Chinese man who was admitted with weakness in the extremities, muscle pain, and dark-colored urine. He had consumed liquorice water daily for seven days prior to admission. The laboratory tests revealed a serum potassium level of 1.84 mmol/L, magnesium 0.68 mmol/L, creatinine phosphokinase (CK) 10117 IU/L, and marked hemoglobinuria. Fractional chloride excretion and fractional magnesium excretion were increased. Plasma renin activity and aldosterone concentration were within the normal ranges. Sequence analysis of the SLC12A3 gene revealed that he had compound heterozygous mutations. The diagnosis of liquorice-induced severe hypokalemic rhabdomyolysis with GS and diabetes was thus genetically confirmed. Serum potassium and CK quickly improved with potassium replacement therapy, hydration, and discontinuation of liquorice ingestion. Upon follow-up at 3 mo, the levels of CK, myoglobin, and potassium remained normal, and magnesium was above 0.6 mmol/L. CONCLUSION This case emphasizes that liquorice consumption and GS should be considered causes of hypokalemia and that the diabetic status of GS patients should be noted in the clinic.

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Low-dose liquorice ingestion resulting in severe hypokalaemic paraparesis, rhabdomyolysis and nephrogenic diabetes insipidus

Cited by 10 publications

References 15 publications

Natural Anti-Inflammatory Compounds as Drug Candidates for Inflammatory Bowel Disease

Natural Anti-Inflammatory Compounds as Drug Candidates for Inflammatory Bowel Disease

Toxicological Effects of Glycyrrhiza glabra (Licorice): A Review

Liquorice-induced severe hypokalemic rhabdomyolysis with Gitelman syndrome and diabetes: A case report

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