Jawad Ahmad1, Joseph A Odin1, Paul H Hayashi2, Robert J Fontana3, Hari Conjeevaram3, Bharathi Avula4, Ikhlas A Khan4, Huiman Barnhart5, Raj Vuppalanchi6, Victor J Navarro7. 1. Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 G. Levy Place, Box 1101, New York, NY, 10029, USA. 2. Department of Medicine, University of North Carolina, Division of Gastroenterology & Hepatology, 8011 Burnett-Womack Bldg, Room 8011, Chapel Hill, 27599-7584, NC, USA. Electronic address: Paul.hayashi@fda.hhs.gov. 3. Department of Medicine, University of Michigan School of Medicine, Division of Gastroenterology & Hepatology, 1500 E. Medical Center, Dr. Ann Arbor, MI, 48109, USA. 4. University of Mississippi, National Center for Natural Products Research, 3012 Thad Cochran, P.O. Box 1848, University, MS, 38677, USA. 5. Duke Clinical Research Institute, Duke University, 300 West Morgan St. Durham, NC, 27701, USA. 6. Department of Medicine Indiana University School of Medicine, 702 Rotary Circle, Suite 225, Indianapolis, IN, 46202, USA. 7. Department of Digestive Disease and Transplantation, Einstein Healthcare Network, Klein 505, 5501 Old York Road, Einstein Medical Center, Philadelphia, PA, 19141, USA. Electronic address: NavarroV@einstein.edu.
Abstract
BACKGROUND: Kratom is a botanical product used as an opium substitute with abuse potential. METHODS: Assessment of suspected cases of kratom-induced liver injury in a prospective US cohort. RESULTS: Eleven cases of liver injury attributed to kratom were identified with a recent increase. The majority were male with median age 40 years. All were symptomatic and developed jaundice with a median latency of 14 days. The liver injury pattern was variable, most required hospitalization and all eventually recovered. Biochemical analysis revealed active kratom ingredients. CONCLUSION: Kratom can cause severe liver injury with jaundice.
BACKGROUND: Kratom is a botanical product used as an opium substitute with abuse potential. METHODS: Assessment of suspected cases of kratom-induced liver injury in a prospective US cohort. RESULTS: Eleven cases of liver injury attributed to kratom were identified with a recent increase. The majority were male with median age 40 years. All were symptomatic and developed jaundice with a median latency of 14 days. The liver injury pattern was variable, most required hospitalization and all eventually recovered. Biochemical analysis revealed active kratom ingredients. CONCLUSION: Kratom can cause severe liver injury with jaundice.
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