Exacerbation of Autoimmune Hepatitis following Inactivated SARS-CoV-2 Vaccination

Abstract

Autoimmune hepatitis (AIH) is a rare condition that has seldom been reported being reactivated by a coronavirus disease 2019 (COVID-19) vaccination, especially from an inactivated vaccine. This report presents the case of a 64-year-old male with quiescent AIH cirrhosis who exhibited jaundice and constitutional symptoms for three days at two weeks following his second dose of an inactivated vaccine. The patient had complied well with a four-year immunosuppressive medication regimen to treat AIH which maintained normalized liver enzymes. He also abstained from using herbal supplements. At his presentation, his liver chemistry showed acute hepatocellular jaundice, with histology revealing active AIH. Following extensive testing, he was diagnosed with an AIH exacerbation triggered by the COVID-19 vaccine. His symptoms improved following treatment with higher doses of immunosuppressive agents. This report underscores the potential effect of the COVID-19 vaccine on reactivating well-controlled AIH.