A 46-year-old man, VP, was hospitalized after eating 2 pounds of licorice candy every day for 3 weeks. He experienced cardiac arrest, and despite being resuscitated, his organs began to shut down. Doctors discovered that VP had hypokalemia (low potassium levels) and a high white blood cell count. The licorice candy contained glycyrrhizic acid, which blocked the breakdown of cortisol, leading to an accumulation of cortisol in the body. This caused the kidneys to reabsorb sodium and excrete potassium, resulting in hypokalemia. The hypokalemia led to muscle necrosis, heart problems, and eventually, organ failure. Despite treatment, VP's condition deteriorated, and he passed away 32 hours after admission. The case highlights the dangers of consuming large amounts of licorice, particularly if it contains glycyrrhizic acid, and the importance of treating herbal medicines with caution.
Here are the key facts extracted from the text:
1. VP, a 46-year-old man, was admitted to the emergency room after collapsing and becoming unresponsive.
2. VP had been eating 2 pounds of licorice candy every day for 3 weeks before his hospitalization.
3. VP had a history of hepatitis C, which he contracted through shared needles.
4. VP's heart stopped beating in the ambulance, and he had to be resuscitated multiple times.
5. VP's blood test revealed hypokalemia, a low potassium level in the blood.
6. VP's liver was shutting down, and his muscles were breaking down, releasing proteins into the blood.
7. VP's kidneys were also shutting down, and he was no longer producing urine.
8. A blood test revealed that VP had a high white blood cell count.
9. The adrenal glands produce cortisol, a hormone that helps regulate blood pressure and inflammation.
10. Cortisol can also bind to the kidneys, causing them to retain sodium and water in exchange for potassium.
11. Glycyrrhetinic acid, a compound found in licorice, can block the breakdown of cortisol, leading to an accumulation of cortisol in the body.
12. The accumulation of cortisol can cause the kidneys to retain sodium and water, leading to hypokalemia.
13. VP needed 420 milliequivalents of potassium to bring his levels back up to normal.
14. VP's potassium levels were brought back up with IV potassium chloride after 12 hours in the hospital.
15. VP's blood pressure started to normalize after more medicines were given.
16. VP's prognosis was poor, and he eventually passed away 32 hours after presenting to the emergency room.
17. Glycyrrhetinic acid can hang around in the body for weeks, causing problems.
18. The half-life of glycyrrhetinic acid in humans is up to 30 hours.
19. Glycyrrhetinic acid can recirculate in bile from the liver, back into the small intestines, and be reabsorbed into the liver.