Licorice-induced severe hypokalemia with recurrent torsade de pointes

Ann Noninvasive Electrocardiol. 2013 Nov;18(6):593-6. doi: 10.1111/anec.12076. Epub 2013 Sep 9.

Abstract

A 38-year-old obese woman presented with recurrent polymorphic ventricular tachycardia secondary to persistent hypokalemia necessitating more than 40 DC shocks. All endocrine investigations for hypokalemia were negative with impression of "mysterious hypokalemia." On repeated inquiry, a hidden history of licorice use was elicited causing persistent hypokalemia. The case highlights a life threatening complication of licorice use. In addition, it reiterates the importance of repeated history taking in a patient with undiagnosed hypokalemia and torsade de pointes which avoided a device therapy.

Keywords: hypokalemia; licorice; polymorphic ventricular tachycardia; torsade de pointes.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Electric Countershock / methods
  • Electrocardiography / methods
  • Female
  • Follow-Up Studies
  • Glycyrrhiza / adverse effects*
  • Humans
  • Hypokalemia / chemically induced*
  • Hypokalemia / complications
  • Hypokalemia / drug therapy
  • Magnesium Sulfate / therapeutic use
  • Potassium / therapeutic use
  • Severity of Illness Index
  • Tachycardia, Ventricular / chemically induced
  • Tachycardia, Ventricular / complications
  • Tachycardia, Ventricular / therapy
  • Torsades de Pointes / chemically induced*
  • Torsades de Pointes / complications
  • Torsades de Pointes / therapy

Substances

  • Magnesium Sulfate
  • Potassium