Abstract
A patient with a past history of anorexia nervosa developed a hypokalaemic myopathy following a 'flu-like illness. Although she was apparently in remission from anorexia nervosa, the diet was found to be markedly abnormal with an excessive ingestion of liquorice and a low potassium salt intake. The clinical features and investigations, including muscle biopsy, are described. The patient is compared, with 2 reported cases of liquorice-induced myopathy, and the relationship between anorexia nervosa, liquorice and hypokalaemic myopathy is discussed.
Full text
PDF![577](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e5f/2426174/5aae4c04ef2a/postmedj00225-0040.png)
![578](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e5f/2426174/04876d081699/postmedj00225-0041.png)
![579](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e5f/2426174/f5096bf7d4e5/postmedj00225-0042.png)
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Cumming A. M., Boddy K., Brown J. J., Fraser R., Lever A. F., Padfield P. L., Robertson J. I. Severe hypokalaemia with paralysis induced by small doses of liquorice. Postgrad Med J. 1980 Jul;56(657):526–529. doi: 10.1136/pgmj.56.657.526. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gross E. G., Dexter J. D., Roth R. G. Hypokalemic myopathy with myoglobinuria associated with licorice ingestion. N Engl J Med. 1966 Mar 17;274(11):602–606. doi: 10.1056/NEJM196603172741104. [DOI] [PubMed] [Google Scholar]
- LOUIS L. H., CONN J. W. Preparation of glycyrrhizinic acid, the electrolyte-active principle of licorice: its effects upon metabolism and upon pituitary-adrenal function in man. J Lab Clin Med. 1956 Jan;47(1):20–28. [PubMed] [Google Scholar]
- MOLHUYSEN J. A., GERBRANDY J., de VRIES L. A., de JONG J. C., LENSTRA J. B., TURNER K. P., BORST J. G. G. A liquorice extract with deoxycortone-like action. Lancet. 1950 Sep 23;2(6630):381–386. doi: 10.1016/s0140-6736(50)91341-9. [DOI] [PubMed] [Google Scholar]
- Nardone D. A., McDonald W. J., Girard D. E. Mechanisms in hypokalemia: clinical correlation. Medicine (Baltimore) 1978 Sep;57(5):435–446. doi: 10.1097/00005792-197809000-00003. [DOI] [PubMed] [Google Scholar]
- SALASSA R. M., MATTOX V. R., ROSEVEAR J. W. Inhibition of the "mineralocorticoid" activity of licorice by spironolactone. J Clin Endocrinol Metab. 1962 Nov;22:1156–1159. doi: 10.1210/jcem-22-11-1156. [DOI] [PubMed] [Google Scholar]
- Tourtellotte C. R., Hirst A. E. Hypokalemia, muscle weakness, and myoglobinuria due to licorice ingestion. Calif Med. 1970 Oct;113(4):51–53. [PMC free article] [PubMed] [Google Scholar]