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A case of chronic licorice intoxication-induced apparent mineralocorticoid excess syndrome

만성 감초 중독으로 유발된 미네랄코르티코이드 과잉증후군 1예

  • Young Jae Lim (Department of Emergency Medicine, Dong-A University Hospital) ;
  • Ji Eun Kim (Department of Emergency Medicine, Dong-A University Hospital)
  • 임영재 (동아대학교병원 응급의학과) ;
  • 김지은 (동아대학교병원 응급의학과)
  • Received : 2023.11.13
  • Accepted : 2023.12.04
  • Published : 2023.12.31

Abstract

Licorice is a perennial herb belonging to the legume family that mainly grows in northeastern China, Mongolia, Siberia, and other regions. It is used in traditional medicine in the form of dried roots in the East and the West. The main active component of licorice, glycyrrhizin, is known to produce mineralocorticoid effects when consumed chronically, which can lead to apparent mineralocorticoid excess syndrome. Herein, we present the case of a 72-year-old woman who was admitted to the emergency room with severe generalized weakness and difficulty keeping her neck upright, which had developed after daily consumption of licorice-infused water for the past 2 months. Blood tests revealed metabolic alkalosis and severe hypokalemia, and an electrocardiogram showed ventricular bigeminy. The patient was treated with daily potassium and spironolactone supplements, leading to a significant improvement in muscle strength after a week. One week later, the patient was discharged, showing rare ventricular premature contractions on electrocardiography, but with no specific complaints. Chronic licorice ingestion leading to hypokalemia and muscle weakness can be life-threatening, necessitating the discontinuation of the causative agent, close monitoring, and cautious supplementation of potassium and spironolactone as treatment.

Keywords

Acknowledgement

Fig. 2를 작성해 주신 정진우 박사님께 감사드린다.

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