Hepatitis Associated with Catha edulis Consumption-A Single-Center Study

Background/Objectives:Catha edulis, also known as Khat, is a stimulant with hepatotoxic properties. Studies reporting laboratory patterns are scarce. The aim was to assess the patterns associated with hepatic dysfunction due to Khat usage. Methods: Patients with liver injury and self-reported Khat consumption presenting to the gastroenterology department at the King Fahad Central Hospital in Jazan between January 2017-May 2024 were retrospectively included in the study. Patients with any signs of cirrhosis or viral hepatitis were excluded to have a more homogenous inclusion. Normal distribution was not assumed; data were presented as the median (IQR or %). Results: Sixty-three patients (of which 62 (98.4%) were male) aged 35 (29-41) years were included in the study. An IgG > 20 g/L was present in 41 (61.5%) patients, and the majority (n = 48, 76.2%) had a hepatocellular injury pattern based on an R-factor > 5. Over half of the patients had at least one positive autoantibody(ANA 47.6%; SMA 55.6% and AMA 4.8%), while 57 (90.5%) patients received immunosuppressive therapy. Conclusions: Khat-induced liver injury seems to be predominantly AIH-like in nature, given the IgG elevation, hepatocellular injury pattern, and relatively high rate of autoantibody positivity.