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2000
Volume 19, Issue 4
  • ISSN: 1574-8871
  • E-ISSN: 1876-1038

Abstract

Purpose

SARS-CoV-2 infection has been associated with the impairment of several organs, including the liver. In addition, cases of autoimmune hepatitis have been described in association with COVID-19 disease. According to some case reports, vaccination has also been suggested to elicit the immune liver disorder.

Case Description

We report on the case series of two middle-aged women developing COVID-19 infection despite a completed vaccination schedule. More interestingly, the infection was followed by the onset of acute hepatitis with a significant increase in the values of liver function tests (x 10 normal values). After ruling out the main causes of liver damage (viral, toxic, .), a diagnosis of autoimmune hepatitis was made and supported by liver histology in both cases. The clinical picture was quickly reverted with immunosuppressive (steroid) therapy, also confirming the diagnosis.

Conclusion

We observed a possible relationship between COVID-19 infection and the onset of autoimmune hepatitis and also described this occurrence in vaccinated subjects. It remains to be clarified whether repeated exposure to viral antigens (vaccination plus true infection) or specific emerging viral genotype (omicron strain) may facilitate the onset of this immune liver disease.

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References

  1. BerlinD.A. GulickR.M. MartinezF.J. Severe covid-19.N. Engl. J. Med.2020383252451246010.1056/NEJMcp200957532412710
    [Google Scholar]
  2. Ramos-CasalsM. Brito-ZerónP. MarietteX. Systemic and organ-specific immune-related manifestations of COVID-19.Nat. Rev. Rheumatol.202117631533210.1038/s41584‑021‑00608‑z33903743
    [Google Scholar]
  3. SignorelloA. LenciI. MilanaM. GrassiG. BaiocchiL. COVID-19 in normal, diseased and transplanted liver.World J. Gastroenterol.202127202576258510.3748/wjg.v27.i20.257634092976
    [Google Scholar]
  4. TanakaA. Autoimmune hepatitis: 2019 update.Gut liver202014443043810.5009/gnl1926132301319
    [Google Scholar]
  5. MuratoriL. LonghiM.S. The interplay between regulatory and effector T cells in autoimmune hepatitis: Implications for innovative treatment strategies.J. Autoimmun.201346748010.1016/j.jaut.2013.06.01623871639
    [Google Scholar]
  6. PoddigheD. MaulenkulT. ZhubanovaG. AkhmaldtinovaL. DossybayevaK. Natural killer T (NKT) cells in autoimmune hepatitis: Current evidence from basic and clinical research.Cells20231224285410.3390/cells1224285438132174
    [Google Scholar]
  7. MarjotT. BuescherG. SebodeM. BarnesE. BarrittA.S.IV ArmstrongM.J. BaldelliL. KennedyJ. MercerC. OzgaA.K. CasarC. SchrammC. MoonA.M. WebbG.J. LohseA.W. contributing Members and Collaborators of ERN RARE-LIVER/COVID-Hep/SECURE-Cirrhosis SARS-CoV-2 infection in patients with autoimmune hepatitis.J. Hepatol.20217461335134310.1016/j.jhep.2021.01.02133508378
    [Google Scholar]
  8. DuengelhoefP. HartlJ. RütherD. SteinmannS. BrehmT.T. WeltzschJ.P. GlaserF. SchaubG.M. SterneckM. SebodeM. Weiler-NormannC. AddoM.M. LütgehetmannM. HaagF. SchrammC. Schulze zur WieschJ. LohseA.W. SARS-CoV-2 vaccination response in patients with autoimmune hepatitis and autoimmune cholestatic liver disease.United European Gastroenterol. J.202210331932910.1002/ueg2.1221835289983
    [Google Scholar]
  9. ChowK.W. PhamN.V. IbrahimB.M. HongK. SaabS. Autoimmune hepatitis-like syndrome following covid-19 vaccination: A systematic review of the literature.Dig. Dis. Sci.20226794574458010.1007/s10620‑022‑07504‑w35486203
    [Google Scholar]
  10. BoettlerT. CsernalabicsB. SaliéH. LuxenburgerH. WischerL. Salimi AlizeiE. ZoldanK. KrimmelL. BronsertP. SchwabenlandM. PrinzM. MoglerC. Neumann-HaefelinC. ThimmeR. HofmannM. BengschB. SARS-CoV-2 vaccination can elicit a CD8 T-cell dominant hepatitis.J. Hepatol.202277365365910.1016/j.jhep.2022.03.04035461912
    [Google Scholar]
  11. Terziroli Beretta-PiccoliB. Mieli-VerganiG. VerganiD. Autoimmmune hepatitis.Cell. Mol. Immunol.202219215817610.1038/s41423‑021‑00768‑834580437
    [Google Scholar]
  12. WraithD.C. GoldmanM. LambertP.H. Vaccination and autoimmune disease: What is the evidence?Lancet200336293961659166610.1016/S0140‑6736(03)14802‑714630450
    [Google Scholar]
  13. ChenY. XuZ. WangP. LiX.M. ShuaiZ.W. YeD.Q. PanH.F. New-onset autoimmune phenomena post-COVID-19 vaccination.Immunology2022165438640110.1111/imm.1344334957554
    [Google Scholar]
  14. BocciaS. RicciardiW. IoannidisJ.P.A. What other countries can learn from Italy during the COVID-19 pandemic.JAMA Intern. Med.2020180792792810.1001/jamainternmed.2020.144732259190
    [Google Scholar]
  15. MathieuE. RitchieH. Ortiz-OspinaE. RoserM. HasellJ. AppelC. GiattinoC. Rodés-GuiraoL. A global database of COVID-19 vaccinations.Nat. Hum. Behav.20215794795310.1038/s41562‑021‑01122‑833972767
    [Google Scholar]
  16. LodatoF. LaroccaA. D’ErricoA. CennamoV. An unusual case of acute cholestatic hepatitis after m-RNABNT162b2 (Comirnaty) SARS-CoV-2 vaccine: Coincidence, autoimmunity or drug-related liver injury.J. Hepatol.20217551254125610.1016/j.jhep.2021.07.00534256064
    [Google Scholar]
  17. RoccoA. SgamatoC. CompareD. NardoneG. Autoimmune hepatitis following SARS-CoV-2 vaccine: May not be a casuality.J. Hepatol.202175372872910.1016/j.jhep.2021.05.03834116081
    [Google Scholar]
  18. SundaresanB. ShirafkanF. RippergerK. RattayK. The role of viral infections in the onset of autoimmune diseases.Viruses202315378210.3390/v1503078236992490
    [Google Scholar]
  19. LenciI. CarnìP. MilanaM. BicajA. SignorelloA. BaiocchiL. Sequence of events leading to primary biliary cholangitis.World J. Gastroenterol.202329375305531210.3748/wjg.v29.i37.530537899786
    [Google Scholar]
  20. DurazoF.A. KristbaumK. MillerJ. SaeianK. SelimM. HongJ.C. De novo autoimmune hepatitis after COVID-19 infection in an unvaccinated patient.Case Reports Hepatol.202220221510.1155/2022/840926936590671
    [Google Scholar]
  21. LiuY. EbingerJ.E. MostafaR. BuddeP. GajewskiJ. WalkerB. JoungS. WuM. BräutigamM. HespingF. RupieperE. SchubertA.S. ZuchtH.D. BraunJ. MelmedG.Y. SobhaniK. ArditiM. Van EykJ.E. ChengS. Fert-BoberJ. Paradoxical sex-specific patterns of autoantibody response to SARS-CoV-2 infection.J. Transl. Med.202119152410.1186/s12967‑021‑03184‑834965855
    [Google Scholar]
  22. ChangR. Yen-Ting ChenT. WangS.I. HungY.M. ChenH.Y. WeiC.C.J. Risk of autoimmune diseases in patients with COVID-19: A retrospective cohort study.EClinicalMedicine20235610178310.1016/j.eclinm.2022.10178336643619
    [Google Scholar]
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  • Article Type:
    Case Report
Keyword(s): Autoimmune hepatitis; COVID-19; liver biopsy; liver enzymes; treatment; vaccination
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