Autoimmune hepatitis after COVID-19 vaccine - more than a coincidence.
Autoimmune hepatitis after COVID-19 vaccine - more than a coincidence.
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DOI：
10.1016/j.jaut.2021.102741
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发表时间：
2021-12
影响因子：
12.8
通讯作者：
Macedo G
中科院分区：
文献类型：
--
作者：
Garrido I;Lopes S;Simões MS;Liberal R;Lopes J;Carneiro F;Macedo G
新冠肺炎大流行仍在全球肆虐，接种疫苗有望带领我们走出这场大流行。尽管疫苗的有效性是毋庸置疑的，但安全性仍然是一个令人担忧的问题。我们报告一例65岁妇女在接种第一剂现代新冠肺炎疫苗两周后发生急性重型自身免疫性肝炎。血清免疫球蛋白G升高，抗核抗体阳性(1：100，斑点状)。肝组织学检查显示汇管束明显扩张，重度界面性肝炎和多个小叶坏死融合灶。她开始使用强的松龙治疗，在临床和分析方面取得了良好的进展。最近的一些报告表明，接种新冠肺炎疫苗可能会导致自身免疫性疾病的发展。据推测，该疫苗可以通过与宿主细胞的交叉反应来扰乱自身耐受性并触发自身免疫反应。因此，医疗保健提供者在大规模接种新冠肺炎疫苗期间必须保持警惕。
The COVID-19 pandemic is still raging across the world and vaccination is expected to lead us out of this pandemic. Although the efficacy of the vaccines is beyond doubt, safety still remains a concern. We report a case of a 65-year-old woman who experienced acute severe autoimmune hepatitis two weeks after receiving the first dose of Moderna-COVID-19 vaccine. Serum immunoglobulin G was elevated and antinuclear antibody was positive (1:100, speckled pattern). Liver histology showed a marked expansion of the portal tracts, severe interface hepatitis and multiple confluent foci of lobular necrosis. She started treatment with prednisolone, with a favorable clinical and analytical evolution. Some recent reports have been suggested that COVID-19 vaccination can lead to the development of autoimmune diseases. It is speculated that the vaccine can disturb self-tolerance and trigger autoimmune responses through cross-reactivity with host cells. Therefore, healthcare providers must remain vigilant during mass COVID-19 vaccination.