Abstract Rationale: Excessive ingestion of licorice can cause pseudohyperaldosteronism. A few case reports in the available literature have described significant hypokalemia secondary to licorice consumption with clinical manifestations of muscle weakness, paralysis, or severe hypertension. To our knowledge, no report has discussed severe asymptomatic hypokalemia associated with licorice consumption. Patient Concerns: A 79-year-old man presented to the urology clinic with a several-month history of urinary frequency and a weak stream. Routine laboratory investigations revealed serum potassium (K+) level of 1.8 mmol/L, and he was immediately admitted to the nephrology department. Diagnoses: He was in a good state of health, and systemic and neurological examinations were unremarkable. However, laboratory investigations revealed severe hypokalemia and metabolic alkalosis accompanied with renal K+ wasting and hypertension, suggesting a state of mineralocorticoid excess. Hormonal studies revealed low serum renin and aldosterone but normal serum cortisol levels. Detailed history taking revealed that he had used licorice tea daily during the preceding 18 months. Interventions and outcome: The patient's serum K+ returned to normal levels after vigorous K+ replacement and discontinuation of licorice intake. He was also diagnosed with benign prostatic hyperplasia during hospitalization and was treated. Lessons: Chronic licorice ingestion can precipitate severe hypokalemia, although patients may remain asymptomatic. This case report indicates that the severity of a patient's clinical presentation depends on individual susceptibility, as well as the dose and duration of licorice intake.

中文翻译：

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与长期摄入甘草有关的严重无症状低钾血症

摘要 理由：过量摄入甘草可导致假性醛固酮增多症。现有文献中的一些病例报告描述了继发于甘草消费的显着低钾血症，临床表现为肌肉无力、瘫痪或严重高血压。据我们所知，没有报告讨论与食用甘草相关的严重无症状低钾血症。患者疑虑：一名 79 岁的男性因数月的尿频和尿流微弱而到泌尿外科就诊。常规实验室检查显示血清钾 (K+) 水平为 1.8 mmol/L，他立即被送入肾内科。诊断：他身体健康，全身和神经系统检查无异常。然而，实验室检查显示严重的低钾血症和代谢性碱中毒伴有肾脏 K+ 消耗和高血压，表明盐皮质激素过量的状态。激素研究显示血清肾素和醛固酮低，但血清皮质醇水平正常。详细的病史记录显示，在过去的 18 个月中，他每天都使用甘草茶。干预和结果：患者的血清 K+ 在剧烈补充 K+ 和停止摄入甘草后恢复到正常水平。他还在住院期间被诊断出患有良性前列腺增生并接受了治疗。经验教训：慢性甘草摄入会引发严重的低钾血症，尽管患者可能保持无症状。该病例报告表明，患者临床表现的严重程度取决于个体易感性，