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Licorice-induced hypokalemic myopathy and hypokalemic renal tubular damage in anorexia nervosa

✍ Scribed by Ishikawa, Shozo ;Kato, Masahiro ;Tokuda, Takahiko ;Momoi, Hiroki ;Sekijima, Yoshiki ;Higuchi, Makoto ;Yanagisawa, Nobuo


Publisher
Wiley (John Wiley & Sons)
Year
1999
Tongue
English
Weight
136 KB
Volume
26
Category
Article
ISSN
0276-3478

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✦ Synopsis


A patient with a history of anorexia nervosa developed licorice-induced hypokalemic myopathy. With potassium replacement, high CPK blood level and myopathic signs returned to normal. However, the patient manifested persistent hypokalemia and impaired renal function to concentrate and acidify the urine. Renal biopsy demonstrated intense degeneration and vacuolation of tubules with a normal glomerus which was consistent with hypokalemic nephropathy. Prolonged hypokalemia in anorexia nervosa is sometimes attributed to surreptitious purging or taking diuretics, but it is necessary to check the urine pH, the urine-specific gravity, and the urine potassium level in order to find underlying renal damage even after hypokalemic myopathy is treated successfully.