Autoimmune hepatitis triggered by SARS-CoV-2 vaccination

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 COVID19 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 (R)). The link between SARS-CoV2 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.

Automated summary

Autoimmune diseases have been reported to develop after SARS-CoV-2 infection, as well as following vaccination against the virus. The potential mechanisms involve molecular mimicry and bystander activation. Further investigation is needed to understand the link between SARS-CoV2 vaccination and autoimmune diseases.