Kratom (from the leaves of Mitragyna speciosa) use can result in a cholestatic hepatitis.
Clinical and laboratory features:
(1) jaundice with dark-colored urine and light-colored stools
(2) elevated serum AST and ALT
(3) elevated serum alkaline phosphatase
(4) elevated serum total bilirubin
Histologic features:
(1) canalicular cholestasis
(2) bile duct injury
(3) zone 3 hepatocellular injury and focal hepatocyte dropout
Discontinuation of kratom and therapy with ursodeoxycholic acid is associated with normalization of the abnormal liver function tests.
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Specialty: Gastroenterology
