Post-COVID-19 polyautoimmunity - Fact or coincidence: A case report

Area of Science:

• Gastroenterology
• Immunology
• Infectious Diseases

Background:

• COVID-19 shares clinical and immunological similarities with systemic autoimmune diseases.
• Rare instances of COVID-19 triggering ulcerative colitis and autoimmune hepatitis have been reported.

Observation:

• A previously healthy, vaccinated male presented with symptoms of chronic colitis, autoimmune pancreatitis, and AIH-like hepatitis two months post-COVID-19 infection.
• Clinical presentation included abdominal pain, nausea, vomiting, and persistent bloody diarrhea.
• Diagnostic workup revealed acute pancreatitis, chronic colitis resembling ulcerative colitis, and findings suggestive of autoimmune pancreatitis and immune-mediated hepatitis.

Findings:

• Treatment with intravenous prednisolone led to rapid improvement in bloody diarrhea within 72 hours.
• Elevated liver enzymes normalized following steroid therapy, with positive autoimmune markers (ANA, anti-smooth muscle antibodies).
• The patient achieved symptom remission on mesalazine and azathioprine, remaining symptom-free seven months post-diagnosis.

Implications:

• A high index of suspicion for autoimmune disorders is warranted in patients with a history of COVID-19.
• Conventional treatments for autoimmune conditions demonstrate efficacy in post-COVID-19 cases.
• Early diagnosis and management can lead to good response and remission rates.