Autoimmune hepatitis or drug‐induced autoimmune hepatitis following Covid‐19 vaccination?

Autoimmune hepatitis (AIH) following coronavirus (COVID‐19) vaccine—No longer exclusive to mRNA vaccine?

“…Fimiano et al indicated that we may either be dealing with drug‐induced acute hepatitis with autoimmune features, or ‘real’ AIH triggered by Covid vaccines. 1 It is interesting to note from our series that vaccine‐induced AIH occurred in both mRNA and non‐mRNA vaccines. mRNA vaccine has been suggested to cause upregulation of immune pathways similar to that in autoimmune diseases.…”

“…We read with great interest the article by Fimiano et al 1 and other reports of the AIH post-COVID-19 vaccine; with the majority of cases associated with the use of the mRNA vaccine. [1][2][3][4] We report a case series on AIH secondary to the COVID-19 vaccine (Table 1). The first case involved a 59-year-old woman with dyslipidaemia who developed jaundice after the second dose of COVID-19 AstraZaneca vaccine (AZD1222).…”

“…However, absence of evidence does not mean evidence of absence. We read with great interest the article by Fimiano et al 1 and other reports of the AIH post‐COVID‐19 vaccine; with the majority of cases associated with the use of the mRNA vaccine. 1 , 2 , 3 , 4 …”

“…mRNA vaccine has been suggested to cause upregulation of immune pathways similar to that in autoimmune diseases. 1 , 2 , 3 , 4 However, AZD1222 is non‐mRNA and uses deactivated adenovirus to trigger an immune response. Hence, the definitive causality of AIH post‐Covid‐19 vaccination is difficult to ascertain but there is a possible causal link.…”

“…mRNA vaccine has been suggested to cause upregulation of immune pathways similar to that in autoimmune diseases. [1][2][3][4] However, AZD1222 is non-mRNA and uses deactivated adenovirus…”