Acute Hepatitis Induced by Kava Kava

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Acute Hepatitis Induced by Kava Kava

C. L. Humberston A1, J. Akhtar A1, E. P. Krenzelok A1

A1 Pittsburgh Poison Center, Children's Hospital of Pittsburgh, University

of Pittsburgh Schools of Pharmacy and Medicine, Pittsburgh, Pennsylvania,

USA

Abstract:

Background. Herbal preparations are available widely and regarded

generally by the public as harmless remedies for a variety of medical

ailments. We report a case of acute hepatitis associated with the use of

kava kava, derived from the root of the pepper plant, Piper methysticum.

It is used in the United States as an antianxiety and sedative agent. Case

report. A previously healthy 14-year-old female was admitted to the

hospital with hepatic failure. Initial therapy, including plasmapheresis,

was unsuccessful and she deteriorated. She ultimately required a liver

transplant and now remains well. The liver biopsy showed hepatocellular

necrosis consistent with chemical hepatitis. A work-up for alternative

causes of liver failure was negative. The patient gave a history of taking

a kava kava–containing product for four months. The use of kava kava and

liver failure, is supported by kava kava use, a negative work-up for

alternative causes of liver failure, and histological changes in the

liver. Conclusions. Health care professionals need to be aware of the

possibility of kava kava–induced hepatotoxicity. The toxicity of these

alternative remedies emphasizes the importance of surveillance programs

and quality control in the manufacture of these products. Clinicians must

remain aware of the toxic potential of herbal products and always inquire

about their intake in cases of unexplained liver injury.

References:

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