Autoimmune Hepatitis–Primary Biliary Cholangitis Overlap Syndrome Triggered by COVID-19

  • Balraj Singh Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA https://orcid.org/0000-0001-7986-6031
  • Parminder Kaur Department of Cardiology, Saint Joseph's University Medical Center, Paterson, NJ, USA
  • Michael Maroules Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA

Keywords

Arthritis, autoimmune disease, COVID-19, SARS-CoV-2, autoimmune hepatitis, AIH, primary biliary cirrhosis, primary biliary cholangitis, overlap syndrome

Abstract

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 infection, has caused the ongoing global pandemic. Initially considered a respiratory disease, it can manifest with a wide range of complications (gastrointestinal, neurological, thromboembolic and cardiovascular) leading to multiple organ dysfunction. A range of immune complications have also been described. We report the case of a 57-year-old man with a medical history of hypertension, prediabetes and beta thalassemia minor, who was diagnosed with COVID-19 and subsequently developed fatigue and arthralgias, and whose blood work showed hyperferritinemia, elevated liver enzymes (AST/ALT/GGT), hypergammaglobulinemia, anti-smooth muscle antibody, anti-mitochondrial antibody, and anti-double-stranded DNA antibodies. The patient was diagnosed with autoimmune hepatitis–primary biliary cholangitis overlap syndrome triggered by COVID-19. To our knowledge, this is the first such case reported.

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References

  • Halpert G, Shoenfeld Y. SARS-CoV-2, the autoimmune virus. Autoimmun Rev 2020;19(12):102695.
  • Rahim MN, Miquel R, Heneghan MA. Approach to the patient with acute severe autoimmune hepatitis. JHEP Rep 2020;2(6):100149.
  • Tanaka A. Autoimmune hepatitis: 2019 update. Gut Liver 2020;14(4):430–438.
  • Onofrio FQ, Hirschfield GM, Gulamhusein AF. A practical review of primary biliary cholangitis for the gastroenterologist. Gastroenterol Hepatol (N Y) 2019;15(3):145–154.
  • Rust C, Beuers U. Overlap syndromes among autoimmune liver diseases. World J Gastroenterol 2008;14(21):3368–3373.
  • Muratori P, Granito A, Pappas G, Pendino GM, Quarneti C, Cicola R, et al. The serological profile of the autoimmune hepatitis/primary biliary cirrhosis overlap syndrome. Am J Gastroenterol 2009;104(6):1420–1425.
  • Published: 2021-02-04

    Issue: LATEST ONLINE (view)

    Section: Articles

    How to cite:
    1.
    Singh B, Kaur P, Maroules M. Autoimmune Hepatitis–Primary Biliary Cholangitis Overlap Syndrome Triggered by COVID-19. EJCRIM 2021;2 doi:10.12890/2021_002264.

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