Pseudohyperaldosteronisme door Arabische dorstlesser

Casuïstiek
18-11-2020
T.M.J. (Diederik) van Bakel, Johan M. van der Klooster, Filip Borst en Louise C. Urlings-Strop

Hypokalemia due to a liquorice-containing thirst-quencher

Background

Liquorice consumption can cause pseudohyperaldosteronism and potentially lead to life-threatening complications. Besides correcting hypokalemia and hypertension, finding the triggering factor for pseudohyperaldosteronism is essential to prevent recurrence.

Case description

A 68-year-old Syrian man presented in the Emergency Department with complaints of fatigue, weakness and exercise-related shortness of breath. Blood tests revealed severe hypokalemia for which suppletion and cardiac rhythm surveillance was necessary. Talking to the patient’s son, it occurred that our patient drank copious amounts of Erk Sous, a thirst-quenching drink made from liquorice. The diagnosis pseudohyperaldosteronism was confirmed by a high level of glycyrrhetinic acid in the patient’s urine. After correction of the hypokalemia, our patient recovered successfully.

Conclusion

Erk Sous is a thirst-quenching drink that can cause pseudohyperaldosteronism. The drink is popular in the Middle East during summer and Ramadan. If a patient from the Middle East presents with hypokalemia and/or hypertension, ask for consumption of Erk Sous.

Conflict of interest and financial support: none declared.