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A hidden cause of hypokalemic paralysis in a patient with prostate cancer
Journal article   Open access   Peer reviewed

A hidden cause of hypokalemic paralysis in a patient with prostate cancer

Chih-Jen Cheng, Yeong-Hwang Chen, Tom Chau and Shih-Hua Lin
Supportive care in cancer, Vol.12(11), pp.810-812
11/01/2004
DOI: 10.1007/s00520-004-0656-8
PMCID: PMC7088087
PMID: 15351880
url
https://doi.org/10.1007/s00520-004-0656-8View
Published (Version of record) Open Access

Abstract

Hypokalemic paralysis is a medical emergency due to the risks of cardiac arrhythmia, respiratory failure, and rhabdomyolysis. Besides supplementing patients with KCl to hasten recovery, the astute physician must search for the underlying cause to avoid missing a treatable and curable disorder. We report on an elderly Korean man who presented with marked limb paralysis, myalgias, and mild hypertension. He had prostate cancer treated with orchiectomy and hormone therapy 2 years previously. The major biochemical abnormalities were hypokalemia (K + : 1.7 mmol/l) associated with high renal K + wasting and metabolic alkalosis (HCO 3 − : 42.6 mmol/l). Low plasma renin activity, low aldosterone concentration, and normal cortisol concentration pointed to a state of pseudohyperaldosteronism. While reviewing his drug history, the patient revealed he had been consuming eight packs (100 ml/pack) of a Korean herbal tonic daily to treat his prostate cancer for the past 2 months. A significant amount of glycyrrhizic acid (0.23 mg/ml), an active ingredient of licorice, was detected in the tonic. Discontinuation of the herbal tonic along with KCl supplementation achieved recovery in 2 weeks. As many complementary/alternative medicines for cancer contain licorice, this must be kept in mind as a cause of hypokalemia in cancer patients.
 Hypokalemia Licorice Paralysis Prostate cancer Short Communication

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