Licorice Poisoning Clinical Presentation

Updated: Feb 09, 2017
  • Author: Seth Schonwald, MD, FACEP; Chief Editor: Asim Tarabar, MD  more...
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Presentation

History

Most patients with licorice poisoning report chronic toxicity from daily excessive ingestion of natural licorice products (not artificial licorice flavoring). Cases of poisoning are mostly chronic in nature, not acute; however, binging on liquorice has also resulted in toxicity. [2] Symptoms of licorice toxicity may include the following:

  • Fatigue and muscle cramping
  • Dark urine (myoglobinuria)
  • Weakness (hypokalemia, myopathies)
  • Polyuria/nocturia (increased extracellular volume)
  • Edema (increased extracellular volume)
  • Dyspnea (pulmonary edema)
  • Headache (hypertension)
  • Paresthesias/dysesthesias (eg, burning sensations of extremities)
  • Impotence and diminished libido
  • Amenorrhea
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Physical Examination

Findings on physical examination may include the following:

  • Edema (peripheral, pulmonary), secondary to increased extracellular fluid from water retention
  • High blood pressure, [19, 20] including dangerously high blood pressure with symptoms such as headache, nausea, vomiting, and hypertensive encephalopathy with strokelike effects (eg, one-sided weakness)
  • Spasms/tetany
  • Hyporeflexia, muscle wasting, weakness, flaccid paralysis [21, 22]
  • Myoglobinuria/rhabdomyolysis [23]
  • Trousseau and Chvostek signs (from hypokalemia with alkalosis)
  • Cardiac arrest, dysrhythmias (rare) from hypokalemia
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