A case of autoimmune hepatitis following administration of the COVID19 vaccine

Abstract

A 73-year-old woman developed jaundice 2 days after receiving her second dose of the SARS-CoV-2 vaccine (Pfizer-BioNTech). She had positive antinuclear and antismooth muscle antibodies and an elevated serum immunoglobulin G level. A liver biopsy revealed massive necrosis. Since her drug-induced lymphocyte stimulation test for the SARS-CoV-2 vaccine was positive, a diagnosis of drug-induced liver injury was initially suggested. Liver functionality test showed no improvement of her condition and she was started on prednisolone. After her liver functionality test was normal, a follow-up liver biopsy was performed. It revealed portal lymphoplasmacytic infiltration with interface hepatitis and rosette formation, which confirmed the diagnosis of autoimmune hepatitis.