Gandhi Darshan, Ahuja Kriti, Quade Alexis, Batts Kenneth P, Patel Love
Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States.
Department of Internal Medicine, Maulana Azad Medical College, New Delhi 110002, Delhi, India.
World J Hepatol. 2020 Oct 27;12(10):863-869. doi: 10.4254/wjh.v12.i10.863.
Kratom is a psychoactive substance that is isolated from the plant . The leaves can be chewed fresh or dried, smoked, or infused similar to herbal teas. The plant leaves have been used by natives of Southeast Asia for centuries. The substance has been used for its stimulant activity at low doses, and as an opium substitute at higher doses due to a morphine like effect.
A 37-year-old female with a history of depression and obesity (body mass index: 32) presented to emergency room with a week-long history of nausea, decreased appetite, fatigue, and two days of jaundice. On admission bilirubin was markedly elevated. Her condition was thought to be due to consumption of Kratom 2 wk before onset of symptoms. Liver biopsy showed changes mimicking primary biliary cholangitis. Patient's symptoms and jaundice improved quickly.
The use of Kratom has been on the rise in recent years across the United States and Europe. Several case reports have associated adverse health impact of Kratom-containing products including death due to its ability to alter levels of consciousness. Only a few case reports have highlighted the hepatotoxic effects of Kratom. Even fewer reports exist describing the detailed histopathological changes.
kratom是一种从植物中分离出来的精神活性物质。其叶子可以新鲜咀嚼、干燥后咀嚼、烟熏或像草药茶一样冲泡。几个世纪以来，东南亚当地人一直在使用这种植物叶子。该物质在低剂量时因其兴奋作用而被使用，在高剂量时由于类似吗啡的作用而被用作鸦片替代品。
一名37岁女性，有抑郁症和肥胖病史（体重指数：32），因一周的恶心、食欲减退、疲劳病史以及两天的黄疸症状就诊于急诊室。入院时胆红素显著升高。她的病情被认为是由于在症状出现前2周服用了kratom。肝脏活检显示出类似原发性胆汁性胆管炎的变化。患者的症状和黄疸迅速改善。
近年来，美国和欧洲使用kratom的情况呈上升趋势。几份病例报告将含kratom产品对健康的不良影响联系起来，包括因其改变意识水平的能力导致死亡。只有少数病例报告强调了kratom的肝毒性作用。描述详细组织病理学变化的报告更少。
