Hypokalaemia: The Dangers of a Sweet Tooth

Abstract

Liquorice is well known to inhibit the renal tubular enzyme 11-β-hydroxysteroid dehydrogenase, causing a syndrome of apparent mineralocorticoid excess. This is a rare condition, usually resulting from chronic ingestion of liquorice-containing products. The case report relates to an 84-year-old woman with chronic hypertension who developed profound weakness following a liquorice ‘binge’ which, to our knowledge, is only the second reported case of profound metabolic disturbance as a result of acute liquorice ingestion. The differential diagnosis of hypokalaemia and the importance of the clinical history are discussed, with a review of medication and analysis of the acid-base status.