Autoimmune hepatitis after SARS-CoV-2 vaccine: New-onset or flare-up?
Autoimmune hepatitis after SARS-CoV-2 vaccine: New-onset or flare-up?
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DOI：
10.1016/j.jaut.2021.102745
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发表时间：
2021-12
影响因子：
12.8
通讯作者：
Abasiyanik F
中科院分区：
文献类型：
--
作者：
Avci E;Abasiyanik F
严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染已被报道可引发多种自身免疫性疾病。最近也有关于SARS-CoV-2疫苗接种后发生自身免疫性疾病的报道。自身免疫性肝炎是一种多基因多因素疾病，使用评分系统进行诊断。一位61岁女性，因不适、疲劳、食欲不振、恶心和眼睛发黄而就诊。一个月前，她接种了辉瑞/BioNTech BNT 162 b2 mRNA疫苗。她的体格检查发现全身都有黄疸，特别是巩膜。实验室检查显示肝酶和胆红素水平升高。抗核抗体、抗平滑肌抗体阳性，免疫球蛋白G明显升高。肝活检显示组织病理学结果与自身免疫性肝炎（AIH）一致。患者被诊断为AIH并开始接受类固醇治疗。她对类固醇治疗反应迅速。到目前为止，在COVID-19疫苗接种后，已经报告了一些AIH病例。尽管自身免疫反应的确切原因尚不清楚，但由分子模拟诱导的异常免疫应答和旁观者激活被认为是一种潜在机制，尤其是在易感个体中。随着针对SARS-CoV-2的强化疫苗接种的继续，我们想强调的是，临床医生应该谨慎，并在出现类似体征和症状的患者中考虑AIH。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been reported to trigger several autoimmune diseases. There are also recent reports of autoimmune diseases that develop after SARS-CoV-2 vaccines. Autoimmune hepatitis is a polygenic multifactorial disease, which is diagnosed using a scoring system. A 61-year-old woman presented with malaise, fatigue, loss of appetite, nausea and yellow eyes. She had a Pfizer/BioNTech BNT162b2 mRNA vaccine a month ago. Her physical examination revealed jaundice all over the body, especially in the sclera. The laboratory tests showed elevated liver enzymes and bilirubin levels. Antinuclear antibody and anti-smooth muscle antibody were positive and immunoglobulin G was markedly elevated. The liver biopsy revealed histopathological findings consistent with autoimmune hepatitis (AIH). The patient was diagnosed with AIH and initiated on steroid therapy. She rapidly responded to steroid therapy. A few cases of AIH have been reported after the COVID-19 vaccine so far. Although the exact cause of autoimmune reactions is unknown, an abnormal immune response and bystander activation induced by molecular mimicry is considered a potential mechanism, especially in susceptible individuals. As intensive vaccination against SARS-CoV-2 continues, we would like to emphasize that clinicians should be cautious and consider AIH in patients presenting with similar signs and symptoms.
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DOI：
10.1089/mab.2013.0090
发表时间：
2014-06-01
影响因子：
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作者：
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通讯作者：
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影响因子：
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影响因子：
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影响因子：
12.8
作者：
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