Ketamine-Induced Cholangiopathy With Concomitant Hemorrhagic Cystitis: An Emerging and Underrecognized Cause of Cholestasis.
Cureus December 1, 2025 Kamran Nazir, Waqas Ahmed, Salman Rafi et al.
Chronic ketamine use can damage both the liver and urinary tract. A 55-year-old woman with recurrent hemorrhagic cystitis and long-term recreational ketamine use had abnormal liver enzymes without symptoms. Imaging showed fatty liver and a beaded pattern of bile duct narrowing, while tests ruled out autoimmune or infectious causes. Bladder biopsy confirmed ketamine-induced cystitis. After stopping ketamine, her liver enzymes improved. This case illustrates that ketamine toxicity can cause cholangiopathy alongside cystitis, an emerging cause of cholestasis and urinary injury.