Case report: Severe respiratory failure caused by licorice.

Area of Science:

• Endocrinology
• Pulmonology
• Herbal Medicine

Background:

• Licorice (Glycyrrhiza glabra) is a widely used herb with known potential adverse effects.
• Common side effects include hypokalemia, metabolic alkalosis, and apparent mineralocorticoid excess (pseudoaldosteronism).

Observation:

• An 80-year-old woman presented with impaired consciousness, hypertension, and hypokalemia.
• She had been consuming dietary supplements and herbal medicines containing licorice for six months.
• Chronic respiratory acidosis was noted during her hospitalization.

Findings:

• Hormone tests confirmed pseudoaldosteronism.
• Chest radiography and pulmonary function tests diagnosed diaphragmatic dysfunction.
• Metabolic alkalosis from licorice likely impaired respiratory muscle function.

Implications:

• This case highlights a rare complication of licorice consumption: diaphragmatic dysfunction.
• It underscores the importance of considering herbal supplement intake in differential diagnoses.
• Caution is recommended when using licorice in elderly patients or those with pre-existing conditions like malnutrition or electrolyte imbalances.