Riyaz Shahzad, Imran Mohammad, Gleeson Dermot, Karajeh Mohammed A
Shahzad Riyaz, Mohammad Imran, Dermot Gleeson, Mohammed A Karajeh, Liver Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, S10 2JF, United Kingdom.
World J Hepatol. 2014 Mar 27;6(3):150-4. doi: 10.4254/wjh.v6.i3.150.
To investigate the potential role of khat in triggering auto immune hepatitis.
Patients with a history of khat use and acute hepatitis were identified using the computer database in the hepatology department at the Royal Hallamshire Hospital. They were then assessed for probability of having autoimmune hepatitis using the revised autoimmune hepatitis scoring criteria.
Six patients were identified. All of them had presented with acute hepatitis on a background of khat. All were male and five of these patients were of Somali origin, while one patient was from Yemen. The patients were given points on the modified autoimmune hepatitis score which is based on their liver enzymes, autoimmune screen, exclusion of viral hepatitis alcohol and drugs, immunoglobulin levels and liver histology. The patients were given a score of -4 for khat use due to its potential to cause drug induced liver injury. Five of these patients scored between 10 and 15 points, placing them in the probable group for having autoimmune hepatitis. All of these patients were treated with prednisolone and demonstrated a good response to immunosuppression.
One possibile cause of hepatotoxicity with khat could be via triggering of autoimmune hepatitis in a genetically susceptible individual. Further studies are needed for confirmation.
探讨巧茶引发自身免疫性肝炎的潜在作用。
利用皇家哈勒姆郡医院肝病科的计算机数据库，识别有巧茶使用史和急性肝炎的患者。然后使用修订后的自身免疫性肝炎评分标准评估他们患自身免疫性肝炎的可能性。
识别出6例患者。他们均以巧茶为背景出现急性肝炎。所有患者均为男性，其中5例患者为索马里裔，1例患者来自也门。根据改良的自身免疫性肝炎评分（基于其肝酶、自身免疫筛查、排除病毒性肝炎、酒精和药物、免疫球蛋白水平及肝脏组织学）给患者打分。因巧茶有导致药物性肝损伤的可能性，给这些患者的巧茶使用记-4分。其中5例患者得分在10至15分之间，将他们归入可能患有自身免疫性肝炎的类别。所有这些患者均接受泼尼松龙治疗，且对免疫抑制表现出良好反应。
巧茶导致肝毒性的一个可能原因可能是在遗传易感性个体中引发自身免疫性肝炎。需要进一步研究加以证实。
