Year 2022 / Volume 114 / Number 9
Letter
SARS-CoV-2 vaccine, a new autoimmune hepatitis trigger?

567-568

DOI: 10.17235/reed.2022.8820/2022

Francisco López Romero-Salazar, Mariña Veras Lista, Elena Gómez-Domínguez, Carolina Ibarrola-Andrés, Raquel Muñoz Gómez, Inmaculada Fernández Vázquez,

Abstract
SARS-CoV2 infection and vaccination against this virus have been related to the development of autoimmune diseases. We report a case of autoimmune hepatitis (AIH) after SARS-COV2 vaccine. Male, 76 years old, with a history of hepatic cirrhosis secondary to primary biliary cholangitis (PBC), compensated, treated with ursodeoxycholic acid and obeticholic acid. The patient received the third dose of the SARS-CoV2 vaccine (BioNTech/Pfizer) in December 2021. In subsequent analytical control, the patient presented altered liver test, with elevation of ALT and AST. Ultrasound was performed, without alterations, and viral causes were ruled out. IgG elevation and positive antinuclear antibodies were observed. A liver biopsy was performed, with findings of intense interface and lobular hepatitis and areas of centrilobular necrosis. The inflammation was predominantly lymphoplasmacytic. The patient was diagnosed with AIH and initiated therapy with steroids and azathioprine, currently with an adequate response. AIH is an immune-mediated disease of uncertain etiology. Cases of AIH with SARS-CoV2 vaccination as a possible trigger have recently been published, with characteristics similar to ours. Some of them had a history of autoimmune pathology, such as this case (PBC). Therefore, it is suggested that vaccination can induce the development of autoimmune pathology in patients at risk. Our reported case reinforces the hypothesis of an association between AIH and the SARS-CoV2 vaccine.
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24/12/2022 3:37:53
Bueno pues yo soy una más, HAI tras vacunación con Pfizer. Biopsia igual a esa. Tenía una alteración en la tiroides subclínica previa, 33 años. Sin tratamiento. Transaminasas antes de la vacunación 15, un mes tras la vacunación 800/700, todo el perfil hepático alterado, ictericia, nauseas, fiebre, artralgias, etc etc no he recibido tratamiento hasta 11 meses después. Desde entonces solo "he vivido y vivo" enferma.


References
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2. Kanduc D, Shoenfeld Y. Molecular mimicry between SARS-CoV-2 spike glycoprotein and mammalian proteomes: implications for the vaccine. Immunologic Research. 2020; 68:310-313. doi: 10.1007/s12026-020-09152-6.
3. Mack C, Adams D, Assis D, Kerkar N, Manns M, Mayo M et al. Diagnosis and Management of Autoimmune Hepatitis in Adults and Children: 2019 Practice Guidance and Guidelines from the American Association for the Study of Liver Diseases. Hepatology. 2020;72(2):671-722. doi: 10.1002/hep.31065.
4. Montón Rodríguez C, Navarro Cortés P, Lluch Garcia P, et al. Autoimmune hepatitis triggered by COVID-19. Revista Española de Enfermedades Digestivas. 2022; 114(1):64-65. doi:10.17235/reed.2021.8045/2021
5. Camacho-Domínguez L, Rodríguez Y, Polo F, Restrepo Gutierrez J, Zapata E, Rojas M et al. COVID-19 vaccine and autoimmunity. A new case of autoimmune hepatitis and review of the literature. Journal of Translational Autoimmunity. 2022; 5:100140. doi: 10.1016/j.jtauto.2022.100140.
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Citation tools
López Romero-Salazar F, Veras Lista M, Gómez-Domínguez E, Ibarrola-Andrés C, Muñoz Gómez R, Fernández Vázquez I, et all. SARS-CoV-2 vaccine, a new autoimmune hepatitis trigger?. 8820/2022


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Publication history

Received: 26/03/2022

Accepted: 29/03/2022

Online First: 04/04/2022

Published: 07/09/2022

Article Online First time: 9 days

Article editing time: 165 days


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