Hypokalemic Myopathy with Myoglobinuria Associated with Licorice Ingestion

THE causes of potassium depletion1 which may lead to myopathy include endogenous or exogenous adrenal hypercorticism, excessive gastrointestinal-fluid losses, kaliuretic agents, Fanconi syndrome2 and other renal tubular defects.3 , 4 The kaliuretic effect of licorice is a less well known cause of potassium depletion.5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Myoglobinuria has been reported to occur in patients with extensive trauma or ischemia of striated muscle, idiopathic recurrent rhabdomyolysis, myopathies due to abnormal glycolysis21 22 and various primary diseases of muscle. It has also been reported in a patient with regional enteritis in whom severe hypokalemia developed during treatment with steroids.23 Myoglobinuria has been reviewed by Hed24 and recently . . .