Hypokalemic Myopathy Induced by Glycyrrhizin with Acute Ascending Paralysis as a Presenting Sign

• Published in: Nihon Kyukyu Igakukai Zasshi 1995/02/15, Vol.6(1), pp.81-86
• Main Authors: Yamaguchi, Takako, Yamawaki, Takemori, Serizawa, Hiroshi, Hamada, Keiki, Kumagai, Naoki, Tsuchimoto, Kanji, Shimada, Hideyo
• Format: Article
• Language: English
• Subjects: ascending paralysis; glycyrrhizin; Guillain-Barré syndrome; hypokalemic myopathy
• ISSN: 0915-924X; 1883-3772
• DOI: 10.3893/jjaam.6.81

This report describes a case of hypokalemic myopathy with acute ascending paralysis as a presenting sign. A 75-year-old female had been treated with glycyrrhizin (150mg/day) for 8 months because of chronic hepatitis. She went to the orthopedic clinic complaining of acute muscle weakness of the lower extremities and was admitted. Myelography and lumbar puncture showed no abnormal findings. Because of progressive tetraplegia, she was referred to our hospital. On admission, her proximal muscle strength was weak and the muscle tendon reflexes in her legs ware absent. Guillain-Barrée syndrome was suspected until blood chemistry studies showed a high concentration of serum creatinine phosphokinase and severe hypokalemia (K 1.6mEq/l). Hypokalemic myopathy induced by glycyrrhizin was diagnosed, and in a few days the patient became able to stand and walk in response to treatment with drip infusion of potassium. It was difficult to make a definitive diagnosis in this case based on the clinical features alone, suggesting importance of careful medication of glycyrrhizin.