Kratom-Associated Pulmonary Toxicity: A Systematic Review of Case Reports and Forensic Series with a Proposed Clinical Phenotype Classification.
Venkatkiran Kanchustambham, Swetha Saladi
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From the abstract
Kratom use has increased, including concentrated 7-hydroxymitragynine products, but pulmonary toxicity has not been systematically synthesized.
Reported results
Twenty-four reports were included: 14 clinical and 10 forensic. Five categories were identified in two tiers: primary pulmonary syndromes-diffuse alveolar hemorrhage (n = 3), acute respiratory distress syndrome (ARDS)/diffuse acute lung injury (n = 3), and eosinophilic/hypersensitivity pneumonitis (n = 2)-and secondary consequences of systemic toxicity-central respiratory depression (n = 6) and post-mortem pulmonary…
Authors' conclusions
Reported kratom-associated pulmonary presentations cluster into five provisional, hypothesis-generating categories spanning primary lung injury and secondary systemic effects. Clinicians should consider kratom and 7-hydroxymitragynine in unexplained acute lung injury, alveolar hemorrhage, eosinophilic pneumonitis, or opioid-type respiratory depression; targeted toxicology and standardized reporting are needed to…