Auto-immune hepatitis following COVID vaccination. Issue 123 (September 2021)

• Record Type: Journal Article
• Authors: Rela, Mohamed; Jothimani, Dinesh; Vij, Mukul; Rajakumar, Akila; Rammohan, Ashwin
• Is Part Of: Journal of autoimmunity. Issue 123(2021)
• Publication Date: 2021-09
• Subjects: COVID-19 -- SARS-CoV-2 -- Vaccination -- Covishield -- Adverse effects -- Molecular mimicry -- Auto-immune hepatitis -- Treatment -- Outcomes -- Pharmacovigilance; Autoimmunity -- Periodicals; Autoimmune diseases -- Periodicals; Autoantibodies -- Periodicals; Autoimmune Diseases -- Periodicals; Auto-immunité -- Périodiques; Maladies auto-immunes -- Périodiques; Electronic journals; 616.978005
• DOI: 10.1016/j.jaut.2021.102688
• Languages: English
• ISSNs: 0896-8411

Abstract

Abstract: Unprecedented loss of life due to the COVID pandemic has necessitated the development of several vaccines in record time. Most of these vaccines have received approval without being extensively whetted for their adverse effect and efficacy profiles. Most adverse effects have been mild, nonetheless, more serious thromboembolic events have also been reported. Autoimmune hepatitis (AIH) can occur in predisposed individuals where an immune mediated reaction against hepatocytes is triggered by environmental factors. Vaccines are a very rare cause of AIH. We report two such cases of AIH triggered by COVID (Covishield) vaccination. While one patient made an uneventful recovery, another succumbed to the liver disease. Ours is the first report of Covishield vaccination related AIH and second ever after any form of COVID vaccination. We hope that our report does not deter COVID vaccination drives. However, we also hope to raise awareness of its potential side effects and the increased role of pharmacovigilance in guiding treatment. Highlights: Autoimmune Hepatitis following any vaccination is very rare. We present the first report of two cases of autoimmune hepatitis following Covishield vaccination. Purported mechanisms include molecular mimicry between the antigenic determinants of the vaccine and human proteins. This report should not deter COVID vaccination drives. The report is aimed at highlighting the role of pharmacovigilance in guiding treatment.