Acute Liver Failure Secondary to Khat (Catha edulis)–Induced Necrotic Hepatitis Requiring Liver Transplantation: Case Report

Roelandt, Philip; George, Christophe; D’Heygere, F; Aerts, Raymond; Monbaliu, Diethard; Laleman, Wim; Cassiman, David; Verslype, Chris; Steenbergen, Werner Van; Pirenne, Jacques; Wilmer, Alexander; Nevens, Frederik

doi:10.1016/j.transproceed.2011.09.032

Cited by 20 publications

(21 citation statements)

References 14 publications

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“…Increased total bilirubin suggests a direct toxic effect of the red variety Catha edulis on liver cells leading to decreased uptake and conjugation of bilirubin and reduced secretion into bile ducts(decreased hepatic clearance) causing a build-up of bilirubin in the blood (Chiasera, 2010;F.H.Al-Hashe, I.Bin-Jaliah, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…The widespread use and popularity is due to its CNSstimulating phenylpropylamines, especially to cathinone (α-aminopropiophenone, 'natural amphetamine') and to a much lesser extent to norpseudoephedrine ('cathine') and norephedrine (Kalix, 1988).Currently, Catha edulis is illegal in the USA, Canada, and many European countries (Roelandt et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

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Effects of red and pale green variety of Catha edulis on liver and kidney of human consumers in Meru county, Kenya

Mworia¹,

Kinge²,

Kahato³

et al. 2017

Int. J. Adv. Multidiscip. Res.

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Catha edulis (miraa) is a large green shrub that grows at high altitudes. It is a well-known tree in Kenya.The leaves of the C.edulis plant contain alkaloids structurally related to amphetamine and they are currently chewed daily by a high proportion of the adult population in Kenya for the resulting pleasant mild stimulant action.The habit of C.edulis chewing is widespread in Kenya especially in C.edulis producing areas and this poses a public health problem.This study was conducted tocompare the effects of red and pale green variety of Catha edulis on human consumers in Meru County. Blood was collected from 198 Catha edulis chewers and 193 non-chewers.Liver biochemical parameters were affected by the red variety Catha edulis chewing which was shown by increased activity of alanine aminotransferase (ALA), total bilirubin (TB) and alkaline phosphatase (ALP) as compared to the pale green variety. Renal biochemical parameters were not affected. In conclusion, red variety Catha edulis is more potent than the pale green variety hence responsible for hepatic toxicity but not renal toxicity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of red and pale green variety of Catha edulis on liver and kidney of human consumers in Meru county, Kenya

Mworia¹,

Kinge²,

Kahato³

et al. 2017

Int. J. Adv. Multidiscip. Res.

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“…This stimulation is typically followed by unpleasant feelings of lethargy, somnolence, and sadness. For chronic users and heavy users, severe depression and psychosis may occur [3,6]. As with amphetamine use, khat users are at increased risk for major cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

“…As with amphetamine use, khat users are at increased risk for major cardiovascular events. Typical adverse events from khat consumption include anxiety, anorexia, hypertension, hyperthermia, and mydriasis, as well as recurring gastrointestinal episodes of esophagitis, gastritis, ulcers, and constipation [3,[5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…With khat use becoming more prevalent, there has been an increased awareness and growing concern about the potential for khat-induced hepatotoxic injury [1,[6][7][8][9][10][11][12][13]. Animal studies published in 2002 have evaluated the toxicological effects of long-term khat ingestion and have shown significant hepatotoxic injury from khat exposure in rabbits [7,8].…”

Section: Discussionmentioning

confidence: 99%

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Chronic Khat (Catha edulis) Ingestion as a Possible Triggering Agent in the Development of Autoimmune Hepatitis

et al. 2016

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We describe the case of a 34-year-old immigrant male from Yemen who presented with liver dysfunction secondary to chronic ingestion of khat, a commonly abused plant found in East Africa and the Arabian Peninsula. The clinical features of this case, in combination with the diagnostic labs, were consistent with a presentation of a khatinduced hepatotoxicity in the form of an advanced autoimmune process. Khat has already been identified in recent literature and case reports to be a hepatotoxic environmental agent, and new literature has now recognized an increased association between khat consumption and the development of autoimmune hepatitis, although no specific mechanism for triggering an autoimmune response has been elucidated. Our patient exhibited biochemical, immunological, and histopathological features of autoimmune hepatitis, which we believe may have precipitated from the patient's chronic khat drug consumption.

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Pharmacological and Toxicological Effects of Catha edulis F. (Khat)

Engidawork

2017

Phytotherapy Research

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Khat chewing is deeply rooted in the culture and tradition of communities in khat belt countries, and its consumption is spread to other countries through the suitcase trade. The aim of this article is to review current knowledge on the chemistry, social, pharmacology and toxicology of khat and its use. Khat produces effect invariably in every system, which is harmful or beneficial in some instances. Harmful effects are observed in heavy users, although firm evidence is lacking. Chewing khat acutely elicits states of euphoria, which is followed by low mood. Khat contains alkaloids with psychostimulant properties, but the effect cannot be totally explained by these alkaloids. It is also not clear whether the effect produced in some organs like liver could be attributed to khat or pesticides sprayed during farming. Although the evidence indicates that khat has adverse effects in most organs, our understanding of the complex interaction between use and effect is incomplete, and causal relationships have not yet been described. Moreover, khat has positioned itself well in the social, economic and political arena. Thus, a multidisciplinary research is required to understand the different dimensions and come up with ways that maximize the benefit while minimizing the risk. Copyright © 2017 John Wiley & Sons, Ltd.

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Acute Liver Failure Secondary to Khat (Catha edulis)–Induced Necrotic Hepatitis Requiring Liver Transplantation: Case Report

Cited by 20 publications

References 14 publications

Effects of red and pale green variety of Catha edulis on liver and kidney of human consumers in Meru county, Kenya

Effects of red and pale green variety of Catha edulis on liver and kidney of human consumers in Meru county, Kenya

Chronic Khat (Catha edulis) Ingestion as a Possible Triggering Agent in the Development of Autoimmune Hepatitis

Pharmacological and Toxicological Effects of Catha edulis F. (Khat)

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