key: cord-0951536-98hnqxko
authors: Rocco, Alba; Sgamato, Costantino; Compare, Debora; Nardone, Gerardo
title: Autoimmune hepatitis following sars-cov-2 VACCINE: MAY not be a casualty
date: 2021-06-09
journal: J Hepatol
DOI: 10.1016/j.jhep.2021.05.038
sha: 0825fcb5f5d9542af3ef977973f3cf230ea6967a
doc_id: 951536
cord_uid: 98hnqxko

nan

patient's pre-treatment score was 19. The patient started a treatment schedule with prednisone at a dose of 1 mg/kg/day and subsequent tapering of 10 mg/week with a progressive improvement of the laboratory tests ( Figure 1 ). Several pathogens, such as Epstein-Barr, varicella-zoster, and hepatitis A viruses, can trigger AIH onset [4] . In addition, some reports described a relationship between vaccination (i.e., Hepatitis A J o u r n a l P r e -p r o o f 4 and influenza virus) and the development of AIH [5] [6] [7] [8] , suggesting a potential role of both virus and vaccine in unmasking AIH in predisposed individuals. Thus, the occurrence of acute or chronic liver disease following viral infection or vaccination should raise the suspicion of AIH in the presence of other autoimmune disorders.

Although the causal link between the SARS-CoV-2 vaccine and AIH cannot be definitively established, our case report suggests that this association could be more than coincidental. Indeed, the medical history negative for liver disease as well as the coexistence of another autoimmune disorder, the reasonable lag time between exposure to the triggering factor, the typical onset of symptoms, the laboratory/histopathological findings and finally and the excellent response to therapy are all pieces of the puzzle that reinforce the hypothesis of an association between AIH and SARS-CoV-2 vaccine.

In summary, since the vaccination campaign against SARS-CoV-2 is reaching extraordinary coverage rates, healthcare providers should be aware of the potential association between the vaccine and the onset of immunomediate-disorders in patients with a history of autoimmune diseases.

J o u r n a l P r e -p r o o f

Autoimmune hepatitis developing after coronavirus disease 2019 (COVID-19) vaccine: Causality or casualty?

Autoimmune hepatitis developing after coronavirus disease 2019 (COVID-19) Vaccine: Causality or casualty?

International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis

Review article: autoimmune hepatitis --current management and challenges

Vaccination as a triggering event for autoimmune hepatitis. Semin Liver Dis

Hepatitis A vaccine associated with autoimmune hepatitis

Autoimmune hepatitis following influenza virus vaccination: Two case reports

Vaccine-related autoimmune hepatitis: the same disease as idiopathic autoimmune hepatitis? Two clinical