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Case Reports
. 2021 Sep:123:102710.
doi: 10.1016/j.jaut.2021.102710. Epub 2021 Jul 28.

Autoimmune hepatitis triggered by SARS-CoV-2 vaccination

Élise Vuille-Lessard  1 , Matteo Montani  2 , Jaume Bosch  3 , Nasser Semmo  4
Affiliations
Case Reports

Autoimmune hepatitis triggered by SARS-CoV-2 vaccination

Élise Vuille-Lessard et al. J Autoimmun. 2021 Sep.

Abstract

The development of autoimmune diseases has been reported after SARS-CoV-2 infection. Vaccination against SARS-CoV-2 could also trigger auto-immunity, as it has been described with other vaccines. An aberrant immune response induced by molecular mimicry and bystander activation, especially in predisposed individuals, is a potential mechanism. We report the case of a 76-year-old woman with Hashimoto thyroiditis and prior COVID-19 infection who developed severe autoimmune hepatitis (with typical features including strongly positive anti-smooth muscle antibody and markedly elevated immunoglobulins G, as well as typical histological findings) following SARS-CoV-2 vaccination (mRNA-1273 SARS-CoV-2 vaccine, Moderna®). The link between SARS-CoV-2 vaccination and the development of autoimmune diseases needs to be further investigated. Although a causality relationship cannot be proven, caution may be warranted when vaccinating individuals with known autoimmune diseases.

Keywords: Autoimmune hepatitis; COVID-19; SARS-CoV-2; Vaccination.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Histological findings of autoimmune hepatitis after SARS-CoV-2 vaccination. Panel A: Medium‐magnification image (hematoxylin‐eosin, x5.88) showing a chronic, markedly active hepatitis including interface hepatitis. Panel B: High‐magnification image (hematoxylin‐eosin, x23.8) showing plasma cells (green arrow), apoptotic bodies (red arrows) and pseudorosettes (blue arrows).
See this image and copyright information in PMC

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