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To chew or not to chew: that's the question
Halil Yildiz1, Mina Komuta2, Constanza Monsalve3
1a Department of Internal Medicine , Saint Luc University Hospital , Brussels , Belgium.
Khat chewing can cause toxic hepatitis, a liver condition presenting with jaundice. This case highlights the importance of considering substance-induced liver injury, even with positive autoantibodies mimicking autoimmune hepatitis.
Area of Science:
- Hepatology
- Toxicology
- Internal Medicine
Background:
- Acute hepatitis presentation in a young adult.
- Exclusion of common viral hepatitis etiologies (A, B, C, E).
Observation:
- Patient presented with nausea, vomiting, and jaundice.
- Elevated antinuclear antibodies (ANA) and anti-actin antibodies.
- Liver biopsy suggested toxic hepatitis.
Findings:
- Khat (Catha edulis) consumption identified as a potential cause.
- Diagnosis of Khat-induced toxic hepatitis.
- High antibody titers mimicked autoimmune hepatitis serology.
Implications:
- Khat use should be considered in differential diagnosis of acute hepatitis.
- Toxic hepatitis can present with autoimmune markers.
- Importance of detailed patient history in diagnosing drug-induced liver injury.
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