S3058 Kratom Induced Acute Liver Injury: A Case Study and Systematic Review of Liver Injury Patterns Due to Kratom

Abstract

While PD-1 inhibitors have revolutionized the treatment of metastatic NSCLC and the drugs are overall well tolerated, a small percentage of patients develop immune mediated liver injury due to reactive cytotoxic T lymphocytes as the reactivated T cells attack other tissues, including the liver. Generally, this has been seen consistently across the entire drug class, not specific to single agents. We present a rare case of immune mediated liver toxicity specific to Pembrolizumab that was subsequently not observed with Nivolumab, despite both drugs having identical mechanisms of actions. Patient has had multiple serial labs and imaging studies showing no progression of her disease, stable on Nivolumab. This case highlights the need for further investigation regarding the mechanism of Immune mediated liver toxicity/ injury that may be specific to single agents and not necessarily a drug class.

Research and publication gaps on kratom and kratom products: a scoping review of current literature

“…Among the identified articles, there were 20 clinical case [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] and 7 case series reports [33][34][35][36][37][38][39] published between 2022 and 2023. A vast majority of articles in the case and case series reports category were from the United States (20 articles).…”