Severe ulcerative colitis induced by COVID-19 vaccination

Area of Science:

• Gastroenterology
• Immunology
• Vaccinology

Background:

• The COVID-19 pandemic necessitated rapid vaccine development.
• Vaccine-induced immune responses are complex and can occasionally lead to autoimmune phenomena.
• Ulcerative colitis (UC) is a chronic inflammatory bowel disease affecting the colon.

Observation:

• A 37-year-old woman presented with severe colitis, characterized by diffuse erythema and ulcerations, following her third COVID-19 vaccination.
• Diagnostic workup, including stool cultures, was negative for infection.
• Pathological examination revealed lymphoplasmacytic and neutrophilic infiltration, consistent with UC.

Findings:

• The patient's colitis significantly improved after treatment with an anti-tumor necrosis factor-α agent.
• Despite clinical improvement, severe colonic stenosis developed as a complication.
• The stenosis was successfully managed with endoscopic balloon dilation.

Implications:

• This case suggests that COVID-19 vaccination could potentially act as a trigger for the onset of ulcerative colitis in predisposed individuals.
• Healthcare providers should consider vaccination history in patients presenting with new-onset inflammatory bowel disease.
• Further research is warranted to understand the mechanisms linking COVID-19 vaccination to UC and to identify at-risk populations.