Severe, Acute Liver Injury and Khat Leaves

To the Editor: The chewing of khat leaves (Catha edulis) is a widespread recreational custom in East Africa and the Arabian Peninsula. The plant contains the alkaloids cathine and cathinone, which have amphetamine-like properties and produce a variety of pleasurable effects. Khat is banned in the United States, but large quantities are nonetheless exported to North America from the United Kingdom, where it is freely available and used widely by immigrant populations. The detrimental personal and social effects of khat are well recognized.1 Both psychiatric illness2 and cardiovascular disease3 have been recorded. We report the results of our . . .