SARS-CoV-2 vaccine, a new autoimmune hepatitis trigger?

Area of Science:

• Immunology
• Hepatology
• Vaccinology

Background:

• SARS-CoV2 infection and vaccination are associated with autoimmune conditions.
• Autoimmune hepatitis (AIH) is an immune-mediated liver disease of unclear etiology.
• Patients with pre-existing autoimmune conditions may be at increased risk.

Observation:

• A 76-year-old male with a history of primary biliary cholangitis (PBC) developed altered liver tests after his third SARS-CoV2 vaccine dose.
• Elevated liver enzymes (ALT, AST), IgG, and positive antinuclear antibodies were noted.
• Liver biopsy revealed intense interface and lobular hepatitis with necrosis.

Findings:

• The patient was diagnosed with autoimmune hepatitis (AIH).
• Treatment with steroids and azathioprine resulted in an adequate response.
• The clinical presentation shares similarities with previously reported AIH cases linked to SARS-CoV2 vaccination.

Implications:

• This case reinforces the hypothesis that SARS-CoV2 vaccination may act as a trigger for AIH in susceptible individuals.
• The findings suggest a potential association between SARS-CoV2 vaccination and the development of autoimmune pathology.
• Further research is warranted to understand the mechanisms and identify at-risk populations.