Severe hypokalaemia with paralysis induced by small doses of liquorice

A, Cumming; Boddy, K.; Brown, J. J.; Fraser, Robert; Lever, A.F.; Padfield, P. L.; Robertson, James I.

doi:10.1136/pgmj.56.657.526

Cited by 40 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A case of flaccid quadriplegia due to profound hypokalemia has been reported to be due to ingestion of small amounts of liquorice contained in a laxative preparation taken in combination with antihypertensive treatment (not specified in the original paper) [32]. The interaction could be due to an additive effect of potassium excretion as both some antihypertensives and liquorice (which possess mineralcorticoid effects) can cause potassium excretion [56,61].…”

Section: Interaction With Antihypertensivesmentioning

confidence: 99%

Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction

Izzo

Carlo

Borrelli

et al. 2005

International Journal of Cardiology

234

128

View full text Add to dashboard Cite

Section: Interaction With Antihypertensivesmentioning

confidence: 99%

Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction

Izzo

Carlo

Borrelli

et al. 2005

International Journal of Cardiology

234

128

View full text Add to dashboard Cite

“…A 70-year old woman was admitted to hospital with a flaccid quadriplegia which proved to be due to severe hypokalemia [43]. The problem turned out to be the result of relatively small amounts of liquorice (G/ycyrrhiza glabra) taken in combination with antihypertensive treatment.…”

Section: Herb-drug Interactionsmentioning

confidence: 99%

Adverse effects of unconventional therapies in the elderly: A systematic review of the recent literature

Ernst

2002

AGE

View full text Add to dashboard Cite

Unconventional therapies are increasingly popular, not least in populations of elderly individuals. This review summarizes the evidence regarding the risk unconventional therapies may entail for the elderly. Computerized literature searches were performed to locate all reports with original data on this topic. Most of the evidence found was anecdotal by nature and thus has obvious limitations. The results show that elderly patients can suffer harm from unconventional therapies. Herbal treatments are associated most frequently with adverse events. They can cause both direct toxicity and unwanted herb-drug interactions. Acupuncture, spinal manipulation and even massage therapy have also been implicated. Indirect risks exist if unconventional therapies are employed as a substitute for conventional treatments. It is concluded that unconventional therapies are not risk-free for elderly patients. All parties involved ought to be educated with a view of minimizing this risk, and more research is needed to increase our understanding of this area.

show abstract

“…An important thing to remem ber is that GIHM may be caused by a very small amount of GL. For example, Cumming et al [25] reported 1 case of weakness following severe hypokalemia caused by the administration of GL in a dose of 94 mg/day for only 11 days.…”

Section: Mechanism O F Gihmmentioning

confidence: 99%

Glycyrrhizin (Licorice)-Induced Hypokalemic Myopathy

et al. 1992

View full text Add to dashboard Cite

Fifty-nine cases of glycyrrhizin (licorice)-induced hypokalemic myopathy (GIHM), 2 females treated in our departments (85 and 73 years old) and 57 cases reported in the literature were studied, and conditions leading to the onset, factors, clinical manifestations, laboratory assessments, muscle biopsy findings, treatment and outcome were discussed. The 59 GIHM cases comprised 32 men, 25 women and 2 patients without record of sex; the average age was 55.2 years. In many cases, conditions leading to the onset of GIHM were habitual licorice ingestion, ingestion of antituberculosis agents containing licorice and long-term ingestion of licorice-containing agents for chronic gastritis, chronic hepatitis or chronic dermatitis. The combined use of hypotensive diuretic agents increased the risk of GIHM in an overwhelming number of cases. The main clinical symptom was flaccid quadriplegia in almost all cases, with muscle pain in 32.2% and peripheral dysesthesia in the extremities, manifested mainly by numbness (27.1 %). Laboratory findings included a mean serum K⁺ value of 1.98 mEq/1 (56 GIHM cases), a mean creatine kinase of 5,385.7 IU/1 (n = 30), a mean blood aldosterone concentration of 2.92 ng/dl (n = 30; normal: 2.0-13.0 ng/dl) and a mean plasma renin activity of 0.17 ng/ml/h (n = 27; normal: 0.8-4.4 ng/ml/h). Muscle biopsy was performed in 17 of the 59 cases with resultant findings of myopathic changes consisting mainly of phagocytosis, necrotic fibers, vacuolar degeneration, together with sporadic neurogenic changes. Complete cure was attained in 57 of the 59 cases of GIHM by discontinued ingestion of glycyrrhizin (licorice) and potassium supplement.

show abstract

Severe hypokalaemia with paralysis induced by small doses of liquorice

Cited by 40 publications

References 16 publications

Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction

Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction

Adverse effects of unconventional therapies in the elderly: A systematic review of the recent literature

Glycyrrhizin (Licorice)-Induced Hypokalemic Myopathy

Contact Info

Product

Resources

About