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Copyright: © 2020 Quinonez J, et al. This is an open access article distributed under the Creative
Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any
medium, provided the original work is properly cited.
ISSN: 2639-3778
International Journal of Hepatology & Gastroenterology ISSN: 2639-3778
Abstract
Kratom is an herbal product that is derived from Southeast Asian Mitragyna speciose tree leaves [1-10]. This compound is used
for many purposes such as stimulation, euphoria, or analgesia [1-10]. It has been recently identified as a drug of abuse by the United
States Drug Enforcement Administration [2,8]. Side-effects from this compound have not been well documented. We describe a case of a
36-year-old female who develop nephrotoxicity after taking an herbal supplement. She took kratom as an adjunctive therapy for back pain
management. She developed right upper quadrant pain and nausea. Laboratory tests showed elevated liver enzymes without evidence
of bile duct obstruction. Liver enzymes normalized several weeks after Kratom discontinuation. We advise clinicians to be vigilant about
Kratom’s hepatotoxic potential on patient health.
Table 1: Summary of the patient’s liver function tests and related lab values.
Date 9/2/2017 3/2/2018 3/6/2018 3/12/2018 3/14/2018 3/16/2018 3/18/2018 3/21/2018 3/26/2018 3/29/2018
Normal Range
Alk Phos 127 234 347 342 316 267 199 163 125 124 35-129
ALT (U/L) 53 180 259 344 508 485 282 172 67 55 10.-65
Bilirubin (mg/
3 0.1-1.5
dL)
Amylase (u/L) 25 25-115
ASM 9 0-19
ACKNOWLEDGEMENT
The authors of this article would like to thank the sponsoring
institution Trios Health for making substantive contribution to the
research of this manuscript.
DISCLOSURE STATEMENT
The authors have no conflicts of interest to declare. Verbal and
written consent was obtained from a patient who participated in this
case report.
AUTHOR CONTRIBUTIONS
Dr. Tegpal Atwal provided the information needed for the
creation of this case report along with supervision. Drs. Jonathan
Figure 1: A Gross section of liver under microscope.
Quinonez helped to create the article.
REFERENCES
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426. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20411370
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of Kratom Users: A Qualitative Analysis. J Psychoactive Drugs. 2015; 47:
360-367. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26595229