Autoimmune hepatitis and primary biliary cholangitis overlap syndrome after mRNA COVID-19 vaccination

Abstract

The overlap syndrome indicates an association between autoimmune hepatitis (AIH) and sclerosis cholangitis or primary biliary cholangitis (PBC). We report a case of a 32-year-old patient who experienced overlap syndrome ten days after receiving the first dose of the mRNA Coronavirus disease-2019 (COVID-19) vaccine. Liver biopsy showed primarily AIH and “overlap syndrome” for PBC. Serum IgG was elevated, and ANA (1/100) and anti-mitochondrial antibody was positive. The patient’s treatment plan included prednisolone, ursodeoxycholic acid and azathioprine. Overlap syndrome related to the mRNA COVID-19 vaccines is a very rare entity. After the histopathological diagnosis of the patient, remission was achieved following treatment.

Keywords

• autoimmune hepatitis
• primary biliary cholangitis
• covid-19 vaccine
• mrna vaccine
• overlap syndrome