Histologic Characterization of Kratom Use-Associated Liver Injury
Why this work is in the frame
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Bibliographic record
Abstract
trees. It has traditionally been used by indigenous people to relieve fatigue and manage pain, diarrhea, or opioid withdrawal. The use of kratom has become more commonplace in the United States for similar purposes. Only rare reports of kratom liver toxicity exist in the literature but without histologic characterization. Herein, we report one case of kratom use-associated liver toxicity in a 38-year-old patient. The patient complained of dark colored urine and light colored stools after using kratom. He had unremarkable physical examination. Laboratory testing at presentation revealed elevated alanine aminotransferase (389 U/L), aspartate aminotransferase (220 U/L), total bilirubin (5.1 mg/dL), and alkaline phosphatase (304 U/L). There was no serology evidence of viral hepatitis A, B, and C. The acetaminophen level at presentation was below detectable limits. Ultrasound examination of the right upper quadrant revealed normal echogenicity and contour of the liver without bile ductal dilatation or disease of the gallbladder. The patient underwent liver biopsy 4 days after the initial presentation which revealed a pattern of acute cholestatic liver injury including zone 3 hepatocellular and canalicular cholestasis, focal hepatocyte dropout, mild portal inflammation, and bile duct injury. Kratom was stopped, the patient improved clinically and biochemically and was discharged 8 days after the initial presentation. To our best knowledge, this is the first case report detailing the histology of kratom use-associated liver injury.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it