S2935 Autoimmune Hepatitis After COVID-19 Vaccine: An Unusual Complication

Post-COVID-19 Cholangiopathy: Clinical and Radiologic Findings

“…The main clinical manifestations of post-COVID-19 cholangiopathy are cholestasis and jaundice, characterized by markedly elevated serum alkaline phosphatase, gamma glutamyl transferase, and bilirubin levels. Although definitive criteria have not been established, the generally accepted definition of post-COVID-19 cholangiopathy includes the presence of severe cholestasis, along with bile duct abnormalities on imaging or pathologic examinations, which had not been documented prior to the onset of COVID-19 [ 3 4 5 ]. Magnetic resonance cholangiopancreaticography (MRCP) is the most widely used diagnostic examination [ 4 ].…”

“…The average time between the initial infection and the diagnosis of post-COVID-19 cholangiopathy ranges from 90 to 118 days [ 6 7 ]. Other consistently reported findings include male predilection, a median age exceeding 50 years [ 3 4 7 8 9 ], and comorbidities such as hypertension or diabetes mellitus [ 4 6 7 10 ]. Pathologically, post-COVID-19 cholangiopathy presents with portal or periportal inflammation and fibrosis, along with findings of bile duct injury, such as vacuolization, regenerative changes, and apoptosis or necrosis of cholangiocytes [ 7 ].…”

“…Although some patients with post-COVID-19 cholangiopathy recover, many ultimately progress to biliary cirrhosis or liver failure, necessitating liver transplantation [ 3 5 ]. According to one report, six (50%) of 12 patients with post-COVID-19 cholangiopathy underwent liver transplantation or were waitlisted for transplantation [ 7 ].…”

“…However, patients may develop severe cholestatic liver injury during the later stages of the disease [ 1 2 ]. A subset of these patients who exhibit features of sclerosing cholangitis are diagnosed as having post-COVID-19 cholangiopathy [ 3 4 5 ], also termed as COVID-19-associated secondary sclerosing cholangitis. Post-COVID-19 cholangiopathy is a relatively new and under-recognized disease entity.…”

Post-COVID-19 cholangiopathy: Current understanding and management options

“…Although COVID-19 results most commonly in a hepatocellular pattern of liver injury, severe cholestasis has also been occasionally noted[ 16 - 20 ]. Roth et al [ 13 ] labeled this unique entity of severe cholestasis as post-COVID-19 cholangiopathy (PCC)[ 21 ].…”