{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:48:06Z","timestamp":1793119686497,"version":"4.5.0"},"reference-count":18,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,3]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>As an emerging toxic recreational drug, kratom use has been associated with a range of adverse effects, but reports of structural changes in the central nervous system are rare. We report a case of a young man in his 20s with a history of anxiety and depression who presented with an altered mental status and anterograde and retrograde amnesia following kratom use. His labs showed elevated alanine aminotransferase and ammonia levels, and his MRI revealed bilateral hippocampal T2 hyperintensity signal changes. Following cessation of kratom and supportive care, the patient improved. This case highlights the importance of considering kratom as a potential cause of neurological symptoms in patients presenting with an altered mental status due to toxic ingestion.<\/jats:p>","DOI":"10.1136\/bcr-2024-262213","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T12:11:31Z","timestamp":1737979891000},"page":"e262213","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Bilateral hippocampal toxicity in a patient using kratom"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6072-0309","authenticated-orcid":false,"given":"Abhinav K","family":"Rao","sequence":"first","affiliation":[{"name":"Internal Medicine, Trident Medical Center, Summerville, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"Lee","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Bodle","sequence":"additional","affiliation":[{"name":"Trident Medical Center, North Charleston, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"2025082709115399000_18.1.e262213.1","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/ADM.0000000000001290","article-title":"Prevalence of Kratom Use Disorder Among Kratom Consumers","volume":"18","author":"Hill","year":"2024","journal-title":"J Addict Med"},{"key":"2025082709115399000_18.1.e262213.2","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2023.1332999","article-title":"Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report","volume":"14","author":"Torrico","year":"2023","journal-title":"Front Psychiatry"},{"key":"2025082709115399000_18.1.e262213.3","article-title":"A Case of Kratom-induced Seizures","volume":"12","author":"Afzal","year":"2020","journal-title":"Cureus"},{"key":"2025082709115399000_18.1.e262213.4","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1177\/1751143717712652","article-title":"Death from Kratom toxicity and the possible role of intralipid","volume":"19","author":"Aggarwal","year":"2018","journal-title":"J Intensive Care Soc"},{"key":"2025082709115399000_18.1.e262213.5","article-title":"Kratom-Induced Psychiatric Decompensation and Paranoid Delusions","volume":"16","author":"Awad","year":"2024","journal-title":"Cureus"},{"key":"2025082709115399000_18.1.e262213.6","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000846"},{"key":"2025082709115399000_18.1.e262213.7","doi-asserted-by":"crossref","unstructured":"Osborne CS , Overstreet AN , Rockey DC , et al . Drug-Induced Liver Injury Caused by Kratom Use as an Alternative Pain Treatment Amid an Ongoing Opioid Epidemic. J Investig Med High Impact Case Rep 2019;7. doi:10.1177\/2324709619826167","DOI":"10.1177\/2324709619826167"},{"key":"2025082709115399000_18.1.e262213.8","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3390\/molecules28217372","article-title":"A Critical Review of the Neuropharmacological Effects of Kratom: An Insight from the Functional Array of Identified Natural Compounds","volume":"28","author":"Hossain","year":"2023","journal-title":"Molecules"},{"key":"2025082709115399000_18.1.e262213.9","first-page":"896","article-title":"Pharmacology and toxicology of kratom","volume":"124","author":"Pohanka","year":"2023","journal-title":"Bratisl Lek Listy"},{"key":"2025082709115399000_18.1.e262213.10","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ebcr.2018.04.002","article-title":"Recurrent seizures from chronic kratom use, an atypical herbal opioid","volume":"10","author":"Tatum","year":"2018","journal-title":"Epilepsy Behav Case Rep"},{"key":"2025082709115399000_18.1.e262213.11","first-page":"355","article-title":"Posterior reversible leukoencephalopathy syndrome after kratom ingestion","volume":"30","author":"Castillo","year":"2017","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"2025082709115399000_18.1.e262213.12","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000751"},{"key":"2025082709115399000_18.1.e262213.13","doi-asserted-by":"crossref","DOI":"10.14309\/crj.0000000000000715","article-title":"Kratom (Mitragyna speciosa)-Induced Hepatitis","volume":"9","author":"Allison","year":"2022","journal-title":"ACG Case Rep J"},{"key":"2025082709115399000_18.1.e262213.14","doi-asserted-by":"crossref","first-page":"103898","DOI":"10.1016\/j.transci.2024.103898","article-title":"Severe jaundice with life-threatening liver failure after Kratom use: Reversed by plasma exchange","volume":"63","author":"Dasgupta","year":"2024","journal-title":"Transfus Apher Sci"},{"key":"2025082709115399000_18.1.e262213.15","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1002\/hep.27612","article-title":"Cholestatic hepatitis from prolonged kratom use: a case report","volume":"61","author":"Dorman","year":"2015","journal-title":"Hepatology"},{"key":"2025082709115399000_18.1.e262213.16","doi-asserted-by":"crossref","first-page":"e550","DOI":"10.1097\/MJT.0000000000000631","article-title":"N-Acetylcysteine for Acute Hepatitis Induced by Kratom Herbal Tea","volume":"25","author":"Mousa","year":"2018","journal-title":"Am J Ther"},{"key":"2025082709115399000_18.1.e262213.17","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1007\/s43440-023-00541-w","article-title":"Mitragynine inhibits hippocampus neuroplasticity and its molecular mechanism","volume":"75","author":"Yunusa","year":"2023","journal-title":"Pharmacol Rep"},{"key":"2025082709115399000_18.1.e262213.18","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.toxlet.2019.11.005","article-title":"Exploration of cytochrome P450 inhibition mediated drug-drug interaction potential of kratom alkaloids","volume":"319","author":"Kamble","year":"2020","journal-title":"Toxicol Lett"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262213","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:12:01Z","timestamp":1756311121000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262213"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,27]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-262213"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262213","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}