4.7 Article

Autoimmune hepatitis after COVID-19 vaccine-more than a coincidence

Journal

JOURNAL OF AUTOIMMUNITY
Volume 125, Issue -, Pages -

Publisher

ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jaut.2021.102741

Keywords

COVID-19 vaccine; Moderna mRNA vaccine; Autoimmune hepatitis

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The case of acute severe autoimmune hepatitis following COVID-19 vaccination highlights the importance of closely monitoring adverse reactions during the vaccination process to ensure safety. Healthcare providers must remain vigilant during mass COVID-19 vaccination to detect and manage potential complications promptly.
The COVID-19 pandemic is still raging across the world and vaccination is expected to lead us out of this pandemic. Although the efficacy of the vaccines is beyond doubt, safety still remains a concern. We report a case of a 65-year-old woman who experienced acute severe autoimmune hepatitis two weeks after receiving the first dose of Moderna-COVID-19 vaccine. Serum immunoglobulin G was elevated and antinuclear antibody was positive (1:100, speckled pattern). Liver histology showed a marked expansion of the portal tracts, severe interface hepatitis and multiple confluent foci of lobular necrosis. She started treatment with prednisolone, with a favorable clinical and analytical evolution. Some recent reports have been suggested that COVID-19 vaccination can lead to the development of autoimmune diseases. It is speculated that the vaccine can disturb self-tolerance and trigger autoimmune responses through cross-reactivity with host cells. Therefore, healthcare providers must remain vigilant during mass COVID-19 vaccination.

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