COVID-19 vaccine and autoimmunity. A new case of autoimmune hepatitis and review of the literature

Camacho-Domínguez, Laura; Rodríguez, Yhojan; Polo, Fernando; Gutiérrez, Juan Carlos Restrepo; Zapata, Elizabeth; Rojas, Manuel; Anaya, Juan-Manuel

doi:10.1016/j.jtauto.2022.100140

Cited by 47 publications

(44 citation statements)

References 62 publications

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“…[ 5 ]. In patients with PCS, a proinflammatory state is evident [ 1 ], suggesting that bystander activation contributes to the emergence of autoimmunity [ 10 ]. In addition, despite the increased risk of death in patients with acute COVID-19 influenced by age, sex, and BMI [ 11 , 12 ], we demonstrate that these factors do not influence the autoimmune response in PCS.…”

Section: Commentarymentioning

confidence: 99%

Autoimmunity is a hallmark of post-COVID syndrome

et al. 2022

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Autoimmunity has emerged as a characteristic of the post-COVID syndrome (PCS), which may be related to sex. In order to further investigate the relationship between SARS-CoV-2 and autoimmunity in PCS, a clinical and serological assessment on 100 patients was done. Serum antibody profiles against self-antigens and infectious agents were evaluated by an antigen array chip for 116 IgG and 104 IgM antibodies. Thirty pre-pandemic healthy individuals were included as a control group. The median age of patients was 49 years (IQR: 37.8 to 55.3). There were 47 males. The median post-COVID time was 219 (IQR: 143 to 258) days. Latent autoimmunity and polyautoimmunity were found in 83% and 62% of patients, respectively. Three patients developed an overt autoimmune disease. IgG antibodies against IL-2, CD8B, and thyroglobulin were found in more than 10% of the patients. Other IgG autoantibodies, such as anti-interferons, were positive in 5–10% of patients. Anti-SARS-CoV-2 IgG antibodies were found in > 85% of patients and were positively correlated with autoantibodies, age, and body mass index (BMI). Few autoantibodies were influenced by age and BMI. There was no effect of gender on the over- or under-expression of autoantibodies. IgG anti-IFN-λ antibodies were associated with the persistence of respiratory symptoms. In summary, autoimmunity is characteristic of PCS, and latent autoimmunity correlates with humoral response to SARS-CoV-2.

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Section: Commentarymentioning

confidence: 99%

Autoimmunity is a hallmark of post-COVID syndrome

et al. 2022

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“…COVID-19 vaccines were shown to be effective and spread throughout the world in 2020–2021. However, some case reports described a relationship between COVID-19 vaccines and autoimmune hepatitis [2 – 16] . There have already been 20 reported cases of autoimmune hepatitis triggered by COVID-19 vaccination (Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although the COVID-19 vaccine was effective and the number of infections in Japan rapidly decreased, severe adverse effects of the vaccine were reported in global phase III clinical trials [1] . Some case reports have described severe liver injury diagnosed as autoimmune hepatitis after COVID-19 vaccination [2 – 16] .…”

Section: Introductionmentioning

confidence: 99%

Autoimmune hepatitis with history of HCV treatment triggered by COVID-19 vaccination: case report and literature review

Hasegawa

Matsuoka

Ishikawa

et al. 2022

Clin J Gastroenterol

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Although vaccines have been effective against the worldwide pandemic of Coronavirus Disease 19 (COVID-19), some case reports have described autoimmune hepatitis triggered by COVID-19 vaccination. Meanwhile, hepatitis C virus (HCV) is known to be related to autoimmune diseases. Here, we report a case of autoimmune hepatitis with history of HCV treatment triggered by COVID-19 vaccination. An 82-year-old woman was referred to our hospital for severe liver injury. She had received a COVID-19 vaccination 7 days prior. She had a history of HCV treatment with direct-acting antivirals 7 years previously. In her blood data, despite HCV antibody positivity, she was negative for HCV RNA by real-time RT-PCR. Anti-nuclear antibody was positive and IgG was elevated. Interface hepatitis and plasma cell infiltration were confirmed pathologically. She was diagnosed as autoimmune hepatitis and her liver injury quickly improved after initiation of steroid administration. This is a first case report of autoimmune hepatitis with history of HCV treatment triggered by COVID-19 vaccination.

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“…Various authors propose that vaccination may not generate new ADs, but rather triggers long-lasting latent autoimmunity ( 6 , 7 ). The strong inflammatory response induced by pattern recognition receptors could act like a relapse trigger of a latent AIH, as shown for other ADs reactivation after SARS-CoV-2 vaccination ( 8 ): this mechanism has been postulated since the early presentation with detectable pathogenic autoantibodies ( 8 ). Other proposed mechanisms are bystander activation and epitope spreading ( 6 ) as well as molecular mimicry ( 7 ).…”

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confidence: 93%