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Simultaneous occurrence of autoimmune hepatitis and autoimmune hemolytic anemia after COVID-19 infection: case report
Ryo Abe1, Naoyuki Hasegawa2, Satoshi Suzuki1
1Department of Gastroenterology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
Clinical Journal of Gastroenterology
|April 23, 2024
Summary
This case study reports the first instance of simultaneous autoimmune hepatitis and autoimmune hemolytic anemia triggered by coronavirus disease 2019 (COVID-19) infection in a teenage girl. Prompt steroid therapy led to significant symptom and marker improvement.
Area of Science:
- Immunology
- Infectious Diseases
- Hepatology
Background:
- Coronavirus disease 2019 (COVID-19) has been linked to various autoimmune conditions.
- While COVID-19-triggered autoimmune hepatitis and autoimmune hemolytic anemia have been reported individually, simultaneous onset is rare.
Observation:
- A 15-year-old female presented with severe anemia and liver injury.
- She had a recent COVID-19 diagnosis and symptoms including sore throat and malaise.
- Clinical presentation included jaundice, elevated liver enzymes, and positive COVID-19 PCR test.
Findings:
- Diagnosis of autoimmune hemolytic anemia confirmed by low hemoglobin/haptoglobin, positive direct Coombs test, and increased urinary urobilinogen.
- Autoimmune hepatitis diagnosed via positive antinuclear antibodies and liver biopsy showing interface hepatitis with plasma cell infiltration.
- The patient's autoimmune conditions were attributed to a preceding COVID-19 infection.
Implications:
- This case highlights the potential for COVID-19 to trigger multiple autoimmune diseases concurrently.
- Early recognition and treatment of these post-COVID-19 autoimmune sequelae are crucial for patient outcomes.
- Further research is warranted to understand the mechanisms linking COVID-19 to autoimmune hepatitis and hemolytic anemia.
