title: Liver injury is common among chronic abusers of ketamine.
abstract: Abuse of ketamine leads to liver injury. We investigated the histopathologic and radiologic features of ketamine abusers with significant liver injury in a cross-sectional survey of 297 consecutive chronic abusers of ketamine with urinary tract dysfunction. Liver biopsy and magnetic resonance cholangiopancreatography were performed in patients with liver injury (concentrations of bilirubin, alkaline phosphatase, and/or alanine aminotransferase >2-fold the upper limit of normal). The prevalence of liver injury was 9.8% (all cases cholestatic). Bile duct injury was observed in all 7 patients assessed by liver biopsy. Two patients had bridging fibrosis despite their young age. Three of 6 patients who underwent magnetic resonance cholangiopancreatography examination were found to have prominent or dilated common bile ducts without obstructions or extrinsic compressions. Ketamine abuse therefore appears to lead to common bile duct dilatation, microscopic bile duct injury, and even significant liver fibrosis.
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong.
authors.forename: Grace Lai-Hung
authors.initials: GL
authors.lastname: Wong
authors.affiliation: Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Chinese University of Hong Kong, Hong Kong; Youth Urological Treatment Centre, Department of Surgery, Chinese University of Hong Kong, Hong Kong.
authors.forename: Yuk-Him
authors.initials: YH
authors.lastname: Tam
authors.affiliation: Youth Urological Treatment Centre, Department of Surgery, Chinese University of Hong Kong, Hong Kong; Division of Urology, Department of Surgery, Chinese University of Hong Kong, Hong Kong.
authors.forename: Chi-Fai
authors.initials: CF
authors.lastname: Ng
authors.affiliation: Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Hong Kong.
authors.forename: Anthony Wing-Hung
authors.initials: AW
authors.lastname: Chan
authors.affiliation: Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Hong Kong.
authors.forename: Paul Cheung-Lung
authors.initials: PC
authors.lastname: Choi
authors.affiliation: Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong.
authors.forename: Winnie Chiu-Wing
authors.initials: WC
authors.lastname: Chu
authors.affiliation: Youth Urological Treatment Centre, Department of Surgery, Chinese University of Hong Kong, Hong Kong; Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, Chinese University of Hong Kong, Hong Kong.
authors.forename: Paul Bo-San
authors.initials: PB
authors.lastname: Lai
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong.
authors.forename: Henry Lik-Yuen
authors.initials: HL
authors.lastname: Chan
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong. Electronic address: wongv@cuhk.edu.hk.
authors.forename: Vincent Wai-Sun
authors.initials: VW
authors.lastname: Wong
mesh_terms: D000328:Adult; D001652:Bile Ducts / Q000473:pathology; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology*; D049448:Cholangiopancreatography, Magnetic Resonance; D003430:Cross-Sectional Studies; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007649:Ketamine / Q000009:adverse effects*; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D015995:Prevalence; D011859:Radiography; D019966:Substance-Related Disorders / Q000150:complications*; D055815:Young Adult
chemical_list: D007649:Ketamine
keywords: Clinical Report; Drug Abuse; Hepatobiliary Disease; Liver Damage