To chew or not to chew: that's the question.
A 25-year-old Somalian man was referred to the department of internal medicine because of nausea, vomiting and jaundice of recent onset. On physical examination, he was frankly icteric without clinical signs of chronic liver disease. Laboratory data showed evidence of acute hepatitis. Viral serologic tests for hepatitis A, B, C and E were negative. Antinuclear antibodies (ANA) were positive (titre 1 : 1280; speckled pattern, NV < 1 : 40) as well anti-actin antibodies (titre 75 UA, NV < 20). A liver biopsy was performed and showed a feature compatible with toxic hepatitis. On further questioning, the patient admitted to daily chew Khat when he was living in Somalia. We concluded to Khat-induced toxic hepatitis together with high-titre anti-nuclear antibody mimicking serologic patterns of auto-immune hepatitis.
['Yildiz|Halil|H|', 'Komuta|Mina|M|', 'Monsalve|Constanza|C|', 'Starkel|Peter|P|', 'Lefebvre|Chantal|C|']
D000328:Adult D000974:Antibodies, Antinuclear D029754:Catha D006505:Hepatitis D006801:Humans D008099:Liver D008297:Male D008409:Mastication D028321:Plant Preparations
Hepatitis Autoimmune hepatitis Catha edulis Herbal medicine Kath