Autoimmune Hepatitis-Like Syndrome Following COVID-19 Vaccination: A Systematic Review of the Literature.
Autoimmune Hepatitis-Like Syndrome Following COVID-19 Vaccination: A Systematic Review of the Literature.
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DOI：
10.1007/s10620-022-07504-w
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发表时间：
2022-09
影响因子：
3.1
通讯作者：
Saab, Sammy
中科院分区：
文献类型：
--
作者：
Chow, Kenneth W.;Pham, Nguyen, V;Ibrahim, Britney M.;Hong, Kimberly;Saab, Sammy
于二零二一年夏季，开始出现病例报告，记录少数个体于接种COVID-19疫苗后患上自身免疫性肝炎（AIH）。这些病例很罕见，也很新奇，我们所知甚少。在我们的系统综述中，我们分析了每一个已发表的AIH病例，并回顾了他们的特征性发现、治疗和结局。 我们检索了2019年12月1日至2021年11月1日的PubMed、Embase和Web of Science。两名研究人员独立地从文章中提取了有关疫苗类型、患者病史、实验室值、组织学结果、治疗方案和病程的信息。 32名患者在接种COVID-19疫苗后出现AIH样综合征。黄疸是最常报告的症状（81%），19%的患者最初无症状，并在常规血液检查中发现肝酶升高。平均丙氨酸转氨酶、天冬氨酸转氨酶和总胆红素分别为1231 U/L、921 U/L和14 mg/dL。抗核抗体阳性率为56%，抗平滑肌抗体阳性率为28%。75%的患者使用类固醇。在97%的患者中观察到改善或完全消退。一名患者在积极的类固醇治疗后死亡。COVID-19疫苗诱导的AIH是一种罕见的相关性，文献中只有32例记录在案。临床医生应警惕AIH的病人谁提出了肝损伤后接种疫苗。这些新发现不应该阻止人们接种疫苗，因为接种疫苗的好处远远超过风险。幸运的是，COVID-19疫苗诱导的AIH似乎可以接受皮质类固醇治疗，并且似乎具有良好的结局。
During the summer of 2021, case reports began to emerge documenting a small number of individuals who developed autoimmune hepatitis (AIH) following COVID-19 vaccination. These cases are rare and novel, and very little is known. In our systematic review, we analyzed every published case of AIH and reviewed their characteristic findings, treatment, and outcomes. We searched PubMed, Embase, and Web of Science from December 1, 2019, to November 1, 2021. Two researchers independently extracted information from the articles about vaccine type, patient history, laboratory values, histology results, treatment regimens, and disease course. Thirty-two patients developed AIH-like syndromes after receiving a COVID-19 vaccine. Jaundice was the most frequently reported symptom (81%), and 19% of patients were initially asymptomatic and presented with elevated liver enzymes found during routine bloodwork. Mean alanine transaminase, aspartate transaminase, and total bilirubin were 1231 U/L, 921 U/L, and 14 mg/dL, respectively. Anti-nuclear antibody was positive in 56%, and anti-smooth muscle antibody in 28% of patients. Steroids were used in 75% of patients. Improvement or complete resolution was seen in 97% of patients. One patient died despite aggressive steroid treatment. COVID-19 vaccine-induced AIH is an uncommon association with just 32 documented cases in the literature. Clinicians should be vigilant for AIH in patients who present with liver injury following vaccination. These new findings should under not deter individuals from getting vaccinated, as the benefits of vaccination far outweigh the risks. Fortunately, COVID-19 vaccine-induced AIH appears amendable to corticosteroid therapy and appears to have a favorable outcome.
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BNT162B2 mRNA COVID-19疫苗的安全性和功效。
DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
影响因子：
0.9
作者：
Hines A;Shen JG;Olazagasti C;Shams S
通讯作者：
Shams S
影响因子：
25.7
作者：
Lohse, Ansgar W.;Chazouilleres, Olivier;Lenzi, Marco
通讯作者：
Lenzi, Marco
影响因子：
4.3
作者：
Berry, P. A.;Smith-Laing, G.
通讯作者：
Smith-Laing, G.
影响因子：
13.5
作者：
Mack, Cara L.;Adams, David;Czaja, Albert J.
通讯作者：
Czaja, Albert J.