🇺🇸 Informational public health resource. Educational reference for legislative and regulatory review.
Kratom Regulatory Review

Published Kratom Case Reports

This page provides an indexed compilation of published clinical case reports involving kratom exposure.

Reports are organized by primary body system: cardiovascular events, fatal toxicology findings, hepatic injury, neurologic complications, psychiatric effects, neonatal outcomes, and additional systemic toxicity.

Case reports describe individual clinical observations and do not establish incidence or causation. They are presented for structured review and reference in legislative and regulatory contexts.

Total Reports Indexed: 69
Cardiovascular (8 Reports)
  • Ventricular fibrillation during football training
    A teenage athlete collapsed during practice after using kratom and caffeine. He developed ventricular fibrillation — a deadly heart rhythm that requires immediate defibrillation to prevent sudden death.
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  • Acute Right Ventricular Dysfunction Associated With Kratom
    A 52-year-old man went into shock after heavy kratom use. Heart imaging showed severe failure of the right side of the heart. Other causes were ruled out. Heart function improved only after supportive care.
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  • Kratom Cardiotoxicity: Reversible Brugada Pattern and QTc Prolongation
    A 25-year-old man developed dangerous electrical changes in his heart rhythm after chronic high-dose kratom use. His ECG showed a Brugada pattern — a condition associated with sudden cardiac death. The changes resolved after stopping kratom.
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  • Ventricular fibrillation in a 44-year-old man
    A previously healthy adult experienced sudden cardiac arrest linked to kratom use. He required emergency resuscitation after developing a lethal heart rhythm.
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  • Cardiac arrest in a young healthy male
    A young adult without known heart disease suffered cardiac arrest shortly after kratom ingestion. This case highlights the potential for sudden collapse in otherwise healthy individuals.
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  • Undifferentiated shock with extreme procalcitonin elevation
    A patient developed severe circulatory collapse after kratom use. Blood tests showed extreme inflammatory markers, and the patient required intensive care support.
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  • Heart failure with rhabdomyolysis after kratom overdose
    A patient developed heart failure along with severe muscle breakdown after heavy kratom ingestion. The case demonstrates multi-organ strain affecting the cardiovascular system.
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  • Editorial: Cardiotoxicities From Mitragyna speciosa Extract
    A cardiology editorial discussing how kratom can disrupt heart electrical activity, potentially trigger fatal arrhythmias, and unmask genetic heart conditions associated with sudden death.
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Fatal Toxicology and Postmortem Reports (6 Reports)
  • Two single-drug fatal intoxications by mitragynine
    Two individuals died with mitragynine (kratom’s primary active compound) identified as the only drug present. These cases document deaths where no other substances were detected.
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  • Postmortem mitragynine distribution in single-drug fatality
    A forensic analysis examining how mitragynine was distributed throughout the body in a fatal case. The report provides detailed toxicology findings confirming kratom exposure at time of death.
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  • Mitragynine concentrations in two fatalities
    Toxicology testing measured levels of mitragynine in two individuals who died. The study compares blood concentrations found after death to help understand potential lethal levels.
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  • Fatal combination of mitragynine and quetiapine
    A death involving both kratom and a prescription psychiatric medication. The report discusses how combining substances may increase the risk of fatal outcomes.
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  • Death from kratom toxicity
    A documented fatality attributed to kratom exposure. The report describes clinical findings and discusses treatment attempts, including the possible role of lipid therapy.
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  • Fatal overdose involving hydromorphone and kratom
    A fatal overdose where both kratom and a prescription opioid (hydromorphone) were present. The case highlights risks of combining kratom with other central nervous system depressants.
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Multi-System Toxicity (9 Reports)
  • Multiorgan dysfunction related to kratom ingestion
    A patient developed failure affecting multiple organ systems after kratom use, including liver, kidney, and cardiovascular complications. This case illustrates how toxicity can extend beyond a single organ.
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  • Rare presentation of kratom toxicity
    An unusual clinical presentation following kratom ingestion that did not follow typical patterns of toxicity, highlighting the unpredictable nature of adverse reactions.
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  • Mitragyna speciosa poisoning
    A documented poisoning case describing symptoms such as altered mental status and systemic instability after kratom ingestion. The patient required emergency medical treatment.
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  • Accidental kratom overdose
    An individual unintentionally consumed a large amount of kratom and developed acute toxicity requiring hospital evaluation. The report details symptoms and clinical management.
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  • Precipitated withdrawal with kratom
    A patient experienced sudden, severe withdrawal symptoms after kratom use interacted with other medications. Symptoms included agitation, gastrointestinal distress, and systemic instability.
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  • Complicated postoperative course secondary to kratom withdrawal
    A surgical patient experienced difficult recovery due to kratom withdrawal after surgery, complicating pain control and stabilization.
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  • Kratom ingestion and emergency care
    A case describing emergency department evaluation and management following kratom ingestion, outlining the clinical challenges in acute care settings.
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  • Complexities of kratom use
    A clinical case highlighting the complicated medical and behavioral effects associated with kratom use, including diagnostic uncertainty and overlapping symptoms.
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  • Comprehensive Review of Mitragyna speciosa Toxicity
    A broad scientific review summarizing laboratory research, animal studies, and human case reports describing liver, kidney, heart, lung, neurologic, and fatal toxicities associated with kratom exposure.
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Hepatic and Gastrointestinal (16 Reports)
  • Kratom-induced liver injury
    A patient developed abnormal liver tests and symptoms of liver damage after using kratom. The injury improved after stopping use.
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  • Kratom use for depression/anxiety during COVID-19
    A patient self-treated anxiety and depression with kratom and later developed medical complications. The case highlights risks of unsupervised use for mental health conditions.
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  • Kratom-induced transaminitis
    A patient developed elevated liver enzymes — a sign of liver inflammation — after kratom use. The abnormalities resolved after discontinuation.
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  • Histologic characterization of kratom-associated liver injury
    A biopsy study showing microscopic damage to liver tissue in a person using kratom, providing visual confirmation of liver injury.
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  • Cholestatic liver injury and conservative management
    A patient developed blocked bile flow due to liver injury associated with kratom. Symptoms improved with supportive care after stopping the product.
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  • Severe cholestatic liver injury mimicking primary biliary cholangitis
    A serious liver condition initially resembling autoimmune disease was ultimately linked to kratom use.
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  • Severe jaundice with life-threatening liver failure
    A patient developed extreme yellowing of the skin and signs of acute liver failure after kratom use, requiring urgent medical care.
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  • Mixed cholestatic-hepatocellular liver injury
    A case showing a combination of bile blockage and direct liver cell damage associated with kratom ingestion.
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  • Acute liver injury
    Sudden liver inflammation occurring shortly after kratom use. Symptoms improved after stopping exposure.
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  • Kratom-induced hepatitis
    Inflammation of the liver linked to kratom ingestion, confirmed through laboratory testing and clinical evaluation.
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  • Drug-induced liver injury during opioid epidemic
    A patient using kratom as an alternative to opioids developed liver injury. The report discusses risks of self-medication.
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  • Common bile duct dilation
    Enlargement of the bile duct observed after kratom use, suggesting disruption of normal bile flow.
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  • Adverse interaction with amitriptyline
    A patient taking both kratom and a prescription antidepressant developed liver and gastrointestinal complications. The case highlights risks of combining substances.
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  • Serotonin syndrome precipitated by Paxlovid
    A dangerous drug interaction occurred after kratom was combined with other medications, leading to serotonin syndrome — a potentially life-threatening condition.
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  • Ischemic Colitis in the Setting of Kratom Use
    A 26-year-old woman developed reduced blood flow to part of her colon, causing severe abdominal pain and bleeding. The condition resolved after stopping kratom.
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  • Hinchey Stage IV Diverticulitis in a Chronic Kratom User
    A 69-year-old man developed bowel perforation and severe infection, likely worsened by chronic constipation associated with long-term kratom use. Emergency surgery was required.
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Neurologic (8 Reports)
  • Kratom-induced seizures
    A patient developed seizure activity after using kratom. The case documents sudden abnormal electrical activity in the brain occurring shortly after exposure.
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  • Seizure and coma following kratom exposure
    An individual experienced a seizure followed by loss of consciousness after kratom ingestion. Hospital evaluation confirmed acute neurologic complications.
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  • Posterior reversible leukoencephalopathy syndrome after ingestion
    A rare brain condition involving swelling and abnormal imaging findings occurred after kratom use. The condition improved with medical treatment and discontinuation.
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  • Transient paralysis
    A patient experienced temporary loss of movement following kratom use. Neurologic symptoms resolved after medical evaluation and supportive care.
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  • Intracerebral hemorrhage linked to adulteration
    A patient suffered bleeding in the brain after consuming kratom that was found to contain additional stimulant adulterants. This case highlights risks from contaminated products.
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  • Reversible ischemic MRI changes with possible link to use
    Brain imaging showed temporary areas of reduced blood flow in a patient using kratom. Changes resolved after stopping use.
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  • An accidental poisoning with mitragynine
    A documented case of accidental kratom exposure resulting in neurologic symptoms and medical intervention.
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  • Recurrent seizures from chronic kratom use
    A patient with long-term kratom use experienced repeated seizures. The report suggests a possible association between chronic use and ongoing neurologic instability.
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Psychiatric and Substance Use (8 Reports)
  • Kratom-induced psychosis
    A patient developed hallucinations and loss of contact with reality after using kratom. Symptoms improved after stopping the substance and receiving psychiatric care.
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  • Psychiatric decompensation and paranoid delusions
    An individual experienced worsening paranoia and severe mental health symptoms associated with kratom use, requiring psychiatric evaluation and stabilization.
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  • Kratom addiction and withdrawal
    A case documenting physical dependence on kratom, including withdrawal symptoms such as anxiety, gastrointestinal distress, and restlessness after stopping use.
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  • Successful management of kratom use disorder with buprenorphine/naloxone
    A patient with kratom dependence was treated using medications commonly used for opioid addiction, demonstrating that kratom can produce withdrawal patterns similar to opioids.
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  • Severe addiction contributing to a suicide attempt
    A case describing heavy kratom use associated with worsening mental health and a suicide attempt. The report highlights the potential psychiatric risks of dependence.
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  • Treatment of kratom use disorder with a tricyclic antidepressant
    A patient with kratom dependence was treated with a prescription antidepressant medication as part of withdrawal and recovery management.
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  • Cannabis and kratom-associated self-amputation
    A severe psychiatric episode involving combined cannabis and kratom use resulted in extreme self-harm behavior. The case illustrates potential risks of substance-induced psychosis.
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  • Kratom: a dangerous player in the opioid crisis
    A report discussing kratom’s role in substance use patterns, including dependence, misuse, and its intersection with the broader opioid epidemic.
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Pediatric (1 Report)
  • Kratom overdose in a pediatric patient
    A child intentionally ingested kratom and developed symptoms requiring emergency medical evaluation. This case highlights the risks of accidental exposure in households.
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Dermatologic (2 Reports)
  • Photodistributed hyperpigmentation as a novel association
    A patient developed dark gray-brown skin discoloration in sun-exposed areas after chronic kratom use. The pigmentation persisted despite treatment.
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  • Photo-exposed hyperpigmentation implicating botanical ingredient
    A second case documenting persistent skin darkening in sun-exposed areas linked to kratom ingestion. Biopsy confirmed melanin deposition.
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Pharmacokinetic / Drug Interaction / General Toxicology (4 Reports)
  • Potential pharmacokinetic interaction case
    A case examining how kratom may interfere with the body’s drug-metabolizing enzymes, potentially increasing levels of other medications.
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  • Examining paradoxical effects
    A report describing unexpected or opposite effects from kratom use, highlighting variability in response.
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  • Anesthetic challenges posed by heavy kratom users
    A surgical patient with heavy kratom use experienced difficulty with anesthesia and pain control, complicating perioperative management.
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  • A case of kratom use
    A general clinical report describing health effects associated with kratom use and diagnostic challenges.
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Endocrine (1 Report)
  • Hyperprolactinemia with secondary hypogonadism
    A patient developed elevated prolactin levels and reduced testosterone after kratom use, leading to hormonal imbalance symptoms.
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Pregnancy and Neonatal (3 Reports)
  • Maternal and neonatal kratom dependence and withdrawal
    A newborn experienced withdrawal symptoms after birth due to maternal kratom use during pregnancy.
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  • Neonatal abstinence syndrome secondary to kratom
    An infant developed opioid-like withdrawal symptoms linked to prenatal kratom exposure.
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  • Unusual cause of neonatal abstinence syndrome
    A newborn presented with withdrawal symptoms that were ultimately linked to maternal kratom use.
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Additional Systemic (3 Reports)
  • Rhabdomyolysis in the context of designer benzodiazepine misuse
    Severe muscle breakdown occurred in a patient using kratom alongside other substances, leading to kidney strain.
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  • Life-threatening hyponatremia secondary to chronic kratom use
    A patient developed dangerously low sodium levels after chronic kratom use, leading to confusion and hospitalization.
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  • Diffuse Alveolar Hemorrhage After Heavy Kratom Ingestion
    A patient developed bleeding into the lungs after heavy kratom use, causing severe breathing difficulty and intensive care treatment.
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