Autoimmune hepatitis triggered by SARS-CoV-2 vaccination. Issue 123 (September 2021)

• Record Type: Journal Article
• Authors: Vuille-Lessard, Élise; Montani, Matteo; Bosch, Jaume; Semmo, Nasser
• Is Part Of: Journal of autoimmunity. Issue 123(2021)
• Publication Date: 2021-09
• Subjects: Autoimmune hepatitis -- SARS-CoV-2 -- COVID-19 -- Vaccination; 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.2021.102710
• Languages: English
• ISSNs: 0896-8411

Abstract

Abstract: The development of autoimmune diseases has been reported after SARS-CoV-2 infection. Vaccination against SARS-CoV-2 could also trigger auto-immunity, as it has been described with other vaccines. An aberrant immune response induced by molecular mimicry and bystander activation, especially in predisposed individuals, is a potential mechanism. We report the case of a 76-year-old woman with Hashimoto thyroiditis and prior COVID-19 infection who developed severe autoimmune hepatitis (with typical features including strongly positive anti-smooth muscle antibody and markedly elevated immunoglobulins G, as well as typical histological findings) following SARS-CoV-2 vaccination (mRNA-1273 SARS-CoV-2 vaccine, Moderna®). The link between SARS-CoV-2 vaccination and the development of autoimmune diseases needs to be further investigated. Although a causality relationship cannot be proven, caution may be warranted when vaccinating individuals with known autoimmune diseases. Highlights: Infections and vaccination have been linked to the development of autoimmune diseases. Molecular mimicry and bystander activation are potential mechanisms. Proving causality between autoimmune hepatitis and mRNA-1273 SARS-CoV-2 vaccine (Moderna®) is challenging. Caution may be warranted when vaccinating individuals with known autoimmune diseases.