Chronic Khat Use as a Possible Contributor to Advanced Liver Cirrhosis: A Case Report

We report the case of a 64-year-old man from Yemen with more than 30 years of daily khat (Catha edulis) use who developed decompensated liver cirrhosis complicated by portal hypertension, hepatic encephalopathy, and severe pulmonary hypertension suggestive of portopulmonary hypertension. Evaluation, including viral hepatitis serologies and polymerase chain reaction testing, autoimmune markers, and metabolic studies, did not identify an alternative etiology of liver disease. His condition progressed to advanced liver failure, and he was ultimately deemed ineligible for liver transplantation due to severe pulmonary hypertension. This case highlights chronic khat use as a possible contributing factor in advanced liver disease and underscores the importance of considering khat exposure in patients from endemic regions presenting with cryptogenic cirrhosis.