Peculiarity of Autoimmune Hepatitis Triggered by SARS-CoV-2 Infection
© EFIM 2024..
Introduction: Recently, medical interest has been growing in SARS-CoV-2 infection and its multiorgan involvement, including the liver. Up until now, a few reports have described autoimmune hepatitis (AIH) triggered by SARS-CoV-2 infection, but no data are available about the specific liver inflammatory infiltrate and cluster of differentiation. We report a case of AIH triggered by SARS-CoV-2 infection, with a particular focus on its histological and mainly immunohistochemical features.
Case description: A 60-year-old man, with a history of paucisymptomatic SARS-CoV-2 infection that occurred one month earlier, was admitted for alterations of hepatocellular necrosis and cholestasis indexes. He completed vaccination for SARS-CoV-2 a year earlier. The serologies for hepatotropic viruses were negative. The anti- smooth muscle antibodies (ASMA) and antinuclear antibodies (ANA) results were positive. Anti-liver kidney microsome (anti-LKM) antibodies and antimitochondrial (AMA) were negative. By liver biopsy, haematoxylin-eosin staining highlighted severe portal inflammation with a rich CD38+ plasma cell component, while immunohistochemical staining showed low cell CD4+ count and prevalence of CD8+ and CD3+. After biopsy, the patient started an immunosuppressant regimen, with benefit.
Discussion: We can conclude that the patient developed a type 1 AIH triggered by SARS-CoV-2 infection. The presence of CD8 T-cells at immunohistochemical examination suggests different mechanisms from classic AIH. Similar cases are described after AIH triggered by SARS-CoV-2 vaccination.
Conclusion: The AIH after SARS-CoV-2 infection developed by the patient showed a histological picture similar to a classic AIH for the abundant presence of plasma cells, and immunohistochemical features similar to those described after SARS-CoV-2-vaccination.
LEARNING POINTS: Recently, medical interest has been growing in SARS-CoV-2 infection and its multiorgan involvement, including the liver. Underlying mechanisms are not still clear, more likely consisting of an inflammatory and immune mediated process rather than a direct cytopathic damage.Our report describes a rare case of type 1 AIH triggered by SARS-CoV-2 infection, showing a peculiar histological pattern, different from classic AIH, conversely similar to AIH triggered by SARS-CoV-2 vaccination.The mechanisms underlying liver involvement in SARS-CoV-2 infection are still under investigation. Further studies should be encouraged to improve understanding on this focus and to support physicians in its management.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2024 |
---|---|
Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
---|---|
Enthalten in: |
European journal of case reports in internal medicine - 11(2024), 1 vom: 03., Seite 004195 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Gallo, Antonella [VerfasserIn] |
---|
Links: |
---|
Themen: |
---|
Anmerkungen: |
Date Revised 16.01.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
---|
doi: |
10.12890/2023_004195 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM367138395 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | NLM367138395 | ||
003 | DE-627 | ||
005 | 20240116232104.0 | ||
007 | cr uuu---uuuuu | ||
008 | 240115s2024 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.12890/2023_004195 |2 doi | |
028 | 5 | 2 | |a pubmed24n1261.xml |
035 | |a (DE-627)NLM367138395 | ||
035 | |a (NLM)38223285 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Gallo, Antonella |e verfasserin |4 aut | |
245 | 1 | 0 | |a Peculiarity of Autoimmune Hepatitis Triggered by SARS-CoV-2 Infection |
264 | 1 | |c 2024 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Revised 16.01.2024 | ||
500 | |a published: Electronic-eCollection | ||
500 | |a Citation Status PubMed-not-MEDLINE | ||
520 | |a © EFIM 2024. | ||
520 | |a Introduction: Recently, medical interest has been growing in SARS-CoV-2 infection and its multiorgan involvement, including the liver. Up until now, a few reports have described autoimmune hepatitis (AIH) triggered by SARS-CoV-2 infection, but no data are available about the specific liver inflammatory infiltrate and cluster of differentiation. We report a case of AIH triggered by SARS-CoV-2 infection, with a particular focus on its histological and mainly immunohistochemical features | ||
520 | |a Case description: A 60-year-old man, with a history of paucisymptomatic SARS-CoV-2 infection that occurred one month earlier, was admitted for alterations of hepatocellular necrosis and cholestasis indexes. He completed vaccination for SARS-CoV-2 a year earlier. The serologies for hepatotropic viruses were negative. The anti- smooth muscle antibodies (ASMA) and antinuclear antibodies (ANA) results were positive. Anti-liver kidney microsome (anti-LKM) antibodies and antimitochondrial (AMA) were negative. By liver biopsy, haematoxylin-eosin staining highlighted severe portal inflammation with a rich CD38+ plasma cell component, while immunohistochemical staining showed low cell CD4+ count and prevalence of CD8+ and CD3+. After biopsy, the patient started an immunosuppressant regimen, with benefit | ||
520 | |a Discussion: We can conclude that the patient developed a type 1 AIH triggered by SARS-CoV-2 infection. The presence of CD8 T-cells at immunohistochemical examination suggests different mechanisms from classic AIH. Similar cases are described after AIH triggered by SARS-CoV-2 vaccination | ||
520 | |a Conclusion: The AIH after SARS-CoV-2 infection developed by the patient showed a histological picture similar to a classic AIH for the abundant presence of plasma cells, and immunohistochemical features similar to those described after SARS-CoV-2-vaccination | ||
520 | |a LEARNING POINTS: Recently, medical interest has been growing in SARS-CoV-2 infection and its multiorgan involvement, including the liver. Underlying mechanisms are not still clear, more likely consisting of an inflammatory and immune mediated process rather than a direct cytopathic damage.Our report describes a rare case of type 1 AIH triggered by SARS-CoV-2 infection, showing a peculiar histological pattern, different from classic AIH, conversely similar to AIH triggered by SARS-CoV-2 vaccination.The mechanisms underlying liver involvement in SARS-CoV-2 infection are still under investigation. Further studies should be encouraged to improve understanding on this focus and to support physicians in its management | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Acute hepatitis | |
650 | 4 | |a COVID-19 | |
650 | 4 | |a autoimmunity | |
700 | 1 | |a Ibba, Francesca |e verfasserin |4 aut | |
700 | 1 | |a Massaro, Maria Grazia |e verfasserin |4 aut | |
700 | 1 | |a Rognoni, Fiammetta |e verfasserin |4 aut | |
700 | 1 | |a Giustiniani, Maria Cristina |e verfasserin |4 aut | |
700 | 1 | |a Ponziani, Francesca Romana |e verfasserin |4 aut | |
700 | 1 | |a Montalto, Massimo |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t European journal of case reports in internal medicine |d 2014 |g 11(2024), 1 vom: 03., Seite 004195 |w (DE-627)NLM246277157 |x 2284-2594 |7 nnns |
773 | 1 | 8 | |g volume:11 |g year:2024 |g number:1 |g day:03 |g pages:004195 |
856 | 4 | 0 | |u http://dx.doi.org/10.12890/2023_004195 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 11 |j 2024 |e 1 |b 03 |h 004195 |