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新型冠状病毒肺炎疫苗接种后暴发性肝炎:一例报告

Fulminant hepatitis following COVID-19 vaccination: A case report.

作者信息

Barary Mohammad, Sharifi-Razavi Athena, Rakhshani Nasser, Sio Terence T, Ebrahimpour Soheil, Baziboroun Mana

机构信息

Student Research Committee, Virtual School of Medical Education and Management Shahid Beheshti University of Medical Sciences Tehran Iran.

Students' Scientific Research Center (SSRC) Tehran University of Medical Sciences Tehran Iran.

出版信息

Clin Case Rep. 2022 Jul 19;10(7):e6066. doi: 10.1002/ccr3.6066. eCollection 2022 Jul.

Abstract

The common side effects of COVID-19 vaccination were mostly self-restricted local reactions that quickly resolved. Nevertheless, rare autoimmune hepatitis cases have been reported in some vaccinated with mRNA COVID-19 vaccines. This article presents a young man who developed fulminant hepatitis a few days after vaccination with the first dose of the AstraZeneca COVID-19 vaccine. A 35-year-old man was admitted to our hospital with generalized weakness, abdominal pain, and jaundice. He received the first dose of the AstraZeneca COVID-19 vaccine 8 days earlier. He was admitted to the hospital with a chief complaint of abdominal pain. On admission and because of his high D-dimers, low platelet count, and low Fibrinogen level, vaccine-induced immune thrombosis thrombocytopenia was suspected, which was ruled out later. Then, after a surge in his liver function tests, decreasing platelet, and abnormal clotting tests, fulminant hepatitis was considered for this patient. Several bacterial, viral, and autoimmune etiologies were then suspected, with all ruled out. Thus, fulminant hepatitis secondary to his AstraZeneca COVID-19 vaccine was confirmed. Unfortunately, he died 3 days later of disseminated intravascular coagulopathy, after which a liver necropsy was performed, indicating drug/toxin-induced hepatitis.

摘要

新冠病毒疫苗的常见副作用大多是可自行缓解的局部反应,很快就会消退。然而,在一些接种了新冠病毒mRNA疫苗的人群中,已有罕见的自身免疫性肝炎病例报告。本文介绍了一名年轻男性,在接种第一剂阿斯利康新冠病毒疫苗几天后出现暴发性肝炎。一名35岁男性因全身乏力、腹痛和黄疸入院。他在8天前接种了第一剂阿斯利康新冠病毒疫苗。他因腹痛为主诉入院。入院时,由于其D-二聚体水平高、血小板计数低和纤维蛋白原水平低,怀疑是疫苗诱导的免疫性血栓形成血小板减少症,后来排除了该诊断。随后,在他的肝功能检查指标飙升、血小板减少以及凝血检查异常后,考虑该患者为暴发性肝炎。接着怀疑了几种细菌、病毒和自身免疫性病因,均被排除。因此,确诊为阿斯利康新冠病毒疫苗继发的暴发性肝炎。不幸的是,他在3天后死于弥散性血管内凝血,之后进行了肝脏尸检,显示为药物/毒素性肝炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b3/9295676/f73a81a8c4d8/CCR3-10-e6066-g001.jpg

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