Abstract
Khat is a plant that is commonly used for its stimulating effects and is chewed for its psychoactive properties. It creates feelings of euphoria that are similar to when taking amphetamines. There is an association between khat and liver injury, but the mechanism is not well known. We present three cases of khat-induced liver injury. All cases have elevated IgG and either positive antinuclear antibodies (ANA) or anti-smooth muscle antibody (ASMA); each case has a different course and requires different management. One case improved only by stopping khat, one required a short course of steroids and the last case required treatment such as that for autoimmune hepatitis (AIH). LEARNING POINTS: This is the first report on different courses and management of khat-induced hepatitis.Although khat-induced AIH is rare, early detection and management have a significant effect on disease remission.Further studies are needed to evaluate the mechanism of how khat-induced autoimmune hepatitis as it is not well understood.