ArticleJHEP reports : innovation in hepatology2023
Histological and serological features of acute liver injury after SARS-CoV-2 vaccination.
Article in JHEP reports : innovation in hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 48 citations in OpenAlex.
- Reply to: "Actin-specific smooth muscle antibodies bridge adult and juvenile autoimmune hepatitis diagnosis".JHEP reports : innovation in hepatology · 2026Article
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- Unmet needs in autoimmune liver diseases.Current opinion in immunology · 2025Review
- Analysis of Hyperexpanded T Cell Clones in SARS-CoV-2 Vaccine-Associated Liver Injury by Spatial Proteomics and Transcriptomics.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
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- Can physiological network mapping reveal pathophysiological insights into emerging diseases? Lessons from COVID-19.PloS one · 2025Article
- The Role of Dental-derived Stem Cell-based Therapy and Their Derived Extracellular Vesicles in Post-COVID-19 Syndrome-induced Tissue Damage.Stem cell reviews and reports · 2024Review
- Diagnostic features of autoimmune hepatitis in SARS‑CoV‑2‑vaccinated vs. unvaccinated individuals.Experimental and therapeutic medicine · 2024Article
- Detection of polyreactive immunoglobulin G facilitates diagnosis in children with autoimmune hepatitis.Hepatology international · 2024Article
- The Epidemiology of Newly Recognized Causes of Drug-Induced Liver Injury: An Update.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Recovery from antibody-mediated biliary ductopenia and multiorgan inflammation after COVID-19 vaccination.NPJ vaccines · 2024Article
- Acute liver injury after SARS-CoV-2 vaccination and luspatercept administration in a patient with β-thalassemia.Annals of hematology · 2024Article
- Roadmap to DILI research in Europe. A proposal from COST action ProEuroDILINet.Pharmacological research · 2024Article
- Defining characteristics and long-term prognosis of drug-induced autoimmune-like hepatitis: A retrospective cohort study.United European gastroenterology journal · 2024Article
- Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report.Journal of hepatology · 2023Review
- Review
- Corticosteroid-refractory autoimmune hepatitis after COVID-19 vaccination: a case report and literature review.Clinical journal of gastroenterology · 2023Review
- Evaluation of immunoserological detection of anti-liver kidney microsomal, anti-soluble liver antigen and anti-mitochondrial antibodies.Scientific reports · 2023Article
- Cases of severe acute liver injury following inactivated SARS-CoV-2 vaccination.Journal of hepatology · 2023Article
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Authors and funding
39 authors at 20 institutions in 14 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background & Aims: Liver injury with autoimmune features after vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is increasingly reported. We investigated a large international cohort of individuals with acute hepatitis arising after SARS-CoV-2 vaccination, focusing on histological and serological features. Methods: Individuals without known pre-existing liver diseases and transaminase levels ≥5x the upper limit of normal within 3 months after any anti-SARS-CoV-2 vaccine, and available liver biopsy were included. Fifty-nine patients were recruited; 35 females; median age 54 years. They were exposed to various combinations of mRNA, vectorial, inactivated and protein-based vaccines. Results: Liver histology showed predominantly lobular hepatitis in 45 (76%), predominantly portal hepatitis in 10 (17%), and other patterns in four (7%) cases; seven had fibrosis Ishak stage ≥3, associated with more severe interface hepatitis. Autoimmune serology, centrally tested in 31 cases, showed anti-antinuclear antibody in 23 (74%), anti-smooth muscle antibody in 19 (61%), anti-gastric parietal cells in eight (26%), anti-liver kidney microsomal antibody in four (13%), and anti-mitochondrial antibody in four (13%) cases. Ninety-one percent were treated with steroids ± azathioprine. Serum transaminase levels improved in all cases and were normal in 24/58 (41%) after 3 months, and in 30/46 (65%) after 6 months. One patient required liver transplantation. Of 15 patients re-exposed to SARS-CoV-2 vaccines, three relapsed. Conclusion: Acute liver injury arising after SARS-CoV-2 vaccination is frequently associated with lobular hepatitis and positive autoantibodies. Whether there is a causal relationship between liver damage and SARS-CoV-2 vaccines remains to be established. A close follow-up is warranted to assess the long-term outcomes of this condition. Impact and implications: Cases of liver injury after vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) have been published. We investigated a large international cohort of individuals with acute hepatitis after SARS-CoV-2 vaccination, focusing on liver biopsy findings and autoantibodies: liver biopsy frequently shows inflammation of the lobule, which is typical of recent injury, and autoantibodies are frequently positive. Whether there is a causal relationship between liver damage and SARS-CoV-2 vaccines remains to be established. Close follow-up is warranted to assess the long-term outcome of this condition.
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