Autoimmune hepatitis after vaccination against COVID-19

Česká verze

Authors: V. Pítová ¹; J. Šperl ¹ ; P. Taimr ¹; O. Fabián ^2,3; T. Miřejovský ²; L. Janoušek ⁴; J. Chlupáč ^4,5; J. Špičák ¹; S. Fraňková ¹
Authors place of work: Klinika hepatogastroenterologie IKEM, Praha ¹; Pracoviště klinické a transplantační patologie IKEM, Praha ²; Ústav patologie a molekulární medicíny 3. LF UK a FTN, Praha ³; Klinika transplantační chirurgie IKEM, Praha ⁴; Ústav anatomie 2. LF UK, Praha ⁵
Published in the journal: Gastroent Hepatol 2023; 77(1): 52-56
Category: Hepatologie: kazuistika
doi: https://doi.org/10.48095/ccgh202352

Summary

In this case report, we present a 61-year-old patient admitted to the hospital because of tiredness and jaundice less than three weeks after vaccination against SARS-CoV-2 with the first dose of the Comirnaty vaccine (Pfizer/BioNTech). Based on the patient’s medical history, laboratory data, imaging methods and liver biopsy, we diagnosed autoimmune hepatitis. The patient developed acute liver failure, and his liver function did not improve after corticosteroid administration. Therefore, the patient was enrolled in the waiting list and underwent a successful orthotopic liver transplantation.

Keywords:

vaccination – liver failure – COVID-19 – autoimmune hepatitis

Zdroje

1. Bril F, Al Diffalha S, Dean M et al. Autoimmune hepatitis developing after coronavirus disease 2019 (COVID-19) vaccine: Causality or casualty? J Hepatol 2021; 75 (1): 222–224. doi: 10.1016/j.jhep.2021.04.003.

2. Sasaki T, Suzuki Y, Ishida K et al. Autoimmune hepatitis following influenza virus vaccination: Two case reports. Medicine (Baltimore) 2018; 97 (30): e11621. doi: 10.1097/MD.000000 0000011621.

3. Berry PA, Smith-Laing G. Hepatitis A vaccine associated with autoimmune hepatitis. World J Gastroenterol 2007; 13 (15): 2238–2239. doi: 10.3748/wjg.v13.i15.2238.

4. Segal Y, Shoenfeld Y. Vaccine-induced autoimmunity: the role of molecular mimicry and immune crossreaction. Cell Mol Immunol 2018; 15 (6): 586–594. doi: 10.1038/cmi.2017.151.

5. Vojdani A, Kharrazian D. Potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases. Clin Immunol 2020; 217: 108480. doi: 10.1016/j.clim.2020.108 480.

6. Londoño MC, Gratacós-Ginès J, Sáez-Peñataro J. Another case of autoimmune hepatitis after SARS-CoV-2 vaccination – still casualty? J Hepatol 2021; 75 (5): 1248–1249. doi: 10.1016/ j.jhep.2021.06.004.

7. Clayton-Chubb D, Schneider D, Freeman E et al. Autoimmune hepatitis developing after the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccine. J Hepatol 2021; 75 (5): 1249–1250. doi: 10.1016/j.jhep.2021.06.014.

8. Tan CK, Wong YJ, Wang LM et al. Autoimmune hepatitis following COVID-19 vaccination: True causality or mere association? J Hepatol 2021; 75 (5): 1250–1252. doi: 10.1016/j.jhep.2021.06.009.

9. McShane C, Kiat C, Rigby J et al. The mRNA COVID-19 vaccine – A rare trigger of autoimmune hepatitis? J Hepatol 2021; 75 (5): 1252–1254. doi: 10.1016/j.jhep.2021.06.044.

10. Lodato F, Larocca A, D‘Errico A et al. An unusual case of acute cholestatic hepatitis after m-RNABNT162b2 (Comirnaty) SARS-CoV-2 vaccine: Coincidence, autoimmunity or drug-related liver injury. J Hepatol 2021; 75 (5): 1254–1256. doi: 10.1016/j.jhep.2021.07.005.

11. Rocco A, Sgamato C, Compare D et al. Autoimmune hepatitis following SARS-CoV-2 vaccine: May not be a casualty. J Hepatol 2021; 75 (3): 728–729. doi: 10.1016/j.jhep.2021.05.038.

12. Rela M, Jothimani D, Vij M et al. Auto-immune hepatitis following COVID vaccination. J Autoimmun 2021; 123: 102688. doi: 10.1016/j.jaut.2021.102688.

13. Vuille-Lessard É, Montani M, Bosch J et al. Autoimmune hepatitis triggered by SARS-CoV-2 vaccination. J Autoimmun 2021; 123: 102710. doi: 10.1016/j.jaut.2021.102710.

14. Ghielmetti M, Schaufelberger HD, Mieli-Vergani G et al. Acute autoimmune-like hepatitis with atypical anti-mitochondrial antibody after mRNA COVID-19 vaccination: A novel clinical entity? J Autoimmun 2021; 123: 102706. doi: 10.1016/j.jaut.2021.102706.

15. Avci E, Abasiyanik F. Autoimmune hepatitis after SARS-CoV-2 vaccine: New-onset or flare-up? J Autoimmun 2021; 125: 102745. doi: 10.1016/j.jaut.2021.102745.

16. Garrido I, Lopes S, Simões MS et al. Autoimmune hepatitis after COVID-19 vaccine – more than a coincidence. J Autoimmun 2021; 125: 102741. doi: 10.1016/j.jaut.2021.102741.

17. Pinazo-Bandera JM, Hernández-Albújar A, García-Salguero AI et al. Acute hepatitis with autoimmune features after COVID-19 vaccine: coincidence or vaccine-induced phenomenon? Gastroenterol Rep (Oxf) 2022; 10: goac014. doi: 10.1093/gastro/goac014.

18. Camacho-Domínguez L, Rodríguez Y, Polo F et al. COVID-19 vaccine and autoimmunity. A new case of autoimmune hepatitis and review of the literature. J Transl Autoimmun 2022; 5: 100140. doi: 10.1016/j.jtauto.2022.100140.

19. Erard D, Villeret F, Lavrut PM et al. Autoimmune hepatitis developing after COVID 19 vaccine: Presumed guilty? Clin Res Hepatol Gastroenterol 2022; 46 (3): 101841. doi: 10.1016/ j.clinre.2021.101841.