Chronic licorice consumption as a rare cause of hypocalcemia

Introduction: Licorice ingestion is well-described with its hypokalemic and hypertensive effects in the literature. To our knowledge, up to now, hypocalcemia due to licorice ingestion has not been described. Our aim is to create awareness for hypocalecemia concomittant with hypokalemia in patients with chronic licorice ingestion.Case Report: A 51-year old male patient presented to our Emergency Department (ED) with complaint of numbness on his whole body. On anamnesis, it was determined that he has been consuming licorice to regulate his hypertension for 3 months. Laboratory analysis revealed hypokalemia and hypocalcemia. After replacement therapy, the patient was discharged from the hospital with full recovery.Conclusion: Focusing on hypokalemia may lead to misdiagnosis of hypocalcemia in patients with chronic licorice ingestion. Physicians must be aware of other electrolyte disturbances not described in the literature yet. 

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  • 1. Janse A, van Iersel M, Hoefnagels WH, Olde Rikker MG. The old lady who liked liquorice: hypertension due to chronic intoxication in a memory-impaired patient. Neth J Med. 2005; 63(4): 149-50.
  • 2. Rohinishree YS, Negi PS. Effect of licorice extract on cell viability, biofilm formation and exotoxin production by Staphylococcus aureus. J Food Sci Technol. 2016; 53(2): 1092-100.
  • 3. Caravaca-Fontan F, Martinez-Saez O, Delgado-Yague M, Yerovi E, Liano F. An Unexpected Cause of Severe Hypokalemia. Case Rep Nephrol. 2015; 2015: 957583.
  • 4. Famularo G, Corsi FM, Giacanelli M. Iatrogenic worsening of hypokalemia and neuromuscular paralysis associated with the use of glucose solutions for potassium replacement in a young woman with licorice intoxication and furosemide abuse. Acad Emerg Med. 1999; 6(9): 960-4.
  • 5. Barrella M, Lauria G, Quatrale R, Paolino E. Hypokaliemic rhabdomyolysis associated with liquoric eingestion: report of an atypical case. Ital J Neurol Sci. 1997; 18(4): 217-20.