Table 2.
Clinical, histological and laboratory characteristics of the cases detected in our centre.
| Patient number | 1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|---|
| Sex | Female | Male | Female | Female | Female |
| Age (years) | 47 | 72 | 62 | 72 | 59 |
| Comorbidities | Hypothyroidism | 30 g/day alcohol consumption, ischemic heart disease | Celiac disease | No comorbidities | Hypothyroidism |
| Vaccine | Astrazeneca (1st dose) | Pfizer (2nd dose) | Astrazeneca (2nd dose) | Pfizer (2nd dose) | Pfizer (1st dose) |
| Latency (days) | 24 | 46 | 4 | 14 | 9 |
| ALT (U/L) | 353 | 248 | 655 | 866 | 1799 |
| AST (U/L) | 241 | 204 | 498 | 570 | 1292 |
| Total bilirubin (mg/dl) | 0.4 | 12.3 | 2.5 | 2.3 | 1.3 |
| IgG (mg/dl) | 2016 | 1670 | 1684 | 1916 | 1978 |
| Autoantibodies tested | ANA+ 1/320 (AC-21 Cytoplasmic reticular/AMA) AMA (−) LKM (−) ASMA (−) M2-3E (−) Sp-100 (−) gp-210 (−) LKM1 (−) LC1 (−) SLA/LP (−) AMA-M2 (−) |
ANA+ 1/1280 (AC-1 homogeneous) AMA (−) LKM (−) ASMA (−) M2-3E (−) Sp-100 (−) gp-210 (−) LKM1 (−) LC1 (−) SLA/LP (−) AMA-M2 (−) |
ANA+ 1/160 (AC-4 fine granular) ENA+ (SS-A+, Ro-52+, SS-B+) AMA (−) LKM (−) ASMA (−) M2-3E (−) Sp-100 (−) gp-210 (−) LKM1 (−) LC1 (−) SLA/LP (−) AMA-M2 (−) |
ANA+ 1/320 (AC-1 homogeneous) AMA (−) LKM (−) ASMA (−) M2-3E (−) Sp-100 (−) gp-210 (−) LKM1 (−) LC1 (−) SLA/LP (−) AMA-M2 (−) |
ANA+ (AC-2, 4, 5 nuclear speckled) AMA (−) LKM (−) ASMA (−) M2-3E (−) Sp-100 (−) gp-210 (−) LKM1 (−) LC1 (−) SLA/LP (−) AMA-M2 (−) |
| Liver biopsy | Mixed portal infiltrate composed mainly of lymphocytes and plasma cells with disruption of the limiting plate, emperipolesis and pseudo-rosette formation. Light-moderate lobular activity. Batts-Ludwig: grade 3, stage 1 |
Moderate interface activity with lymphocyte and plasma cell infiltrate and presence of eosinophils and neutrophils. Moderate-severe lobular activity. Batts-Ludwig: grade 4, stage 2 |
Marked interface activity with disruption of the limiting plate and inflammatory infiltrate composed mainly of lymphocytes and plasma cells, with scattered eosinophils and neutrophils. Moderate-severe lobular activity. Batts-Ludwig: grade 3, stage 2 |
Moderate interface hepatitis with dominant lymphocyte and plasma cell infiltrate and scattered eosinophils. Light lobular activity. Batts-Ludwig: grade 3, stage 2 |
Not performed. |
| HLA | HLA-DRB1 *03:01 *04:03 | HLA-DRB1*04 | HLA-DRB1 *03:01 *07:01 | HLA-DR1 *03:01 *07:01 | HLA-DRB1 *01:03 *11:04 (not susceptibility) |
| AIH Group simplified criteria | 8 | 7 | 8 | 8 | / |
| Exclusion of other causes (DILI, viral) | IgM for HAV, HBV, HCV, HEV, HSV1-2, VZV, CMV, EBV, parvovirus negative. No other drugs |
IgM for HAV, HBV, HCV, HEV, CMV, EBV, parvovirus negative. No other drugs |
IgM for HAV, HBV, HCV, HEV, HSV1-2, VZV, CMV, EBV, parvovirus negative. No other drugs |
IgM for HAV, HBV, HCV, CMV, EBV negative. No other drugs |
IgM for HAV, HBV, HCV, HEV, HSV1-2, VZV, CMV, EBV, parvovirus negative. No other drugs |
| CIOMS-RUCAM related to vaccine | 2 | 3 | 3 | 3 | 6 |
| Treatment (dose of steroids and azathioprine) | Prednisone 20 mg Azathioprine 50 mg |
Prednisone 50 mg (taper 10 mg per week) Azathioprine 50 mg (18 days after initiation of prednisone) |
Prednisone 40 mg (slow taper) Azathioprine 50 mg (14 days after initiation of prednisone) |
Prednisone 50 mg (taper 10 mg per week) No initiation of azathioprine due to endometrial cancer diagnosis |
No treatment received due to spontaneous improvement |
| Time to transaminase normalization | 3 months | 5 weeks | 5 months | 5 months | 5 months |
| New vaccine type (on or off IS?) | 2nd dose of Astrazeneca 3 weeks after diagnosis (on IS treatment) without a worsening in transaminases. 3rd dose of Moderna 8 months after diagnosis (on IS treatment) without a worsening in transaminases. |
3rd dose of Moderna 8 months after diagnosis (on prednisone 2,5 mg only, azathioprine had been removed due to gastrointestinal symptoms) without a worsening in transaminases | 3rd dose Pfizer 5 months after diagnosis (on prednisone 5 mg and azathioprine 100 mg) without a worsening in transaminases | Patient refused 3rd dose | 2nd dose of Pfizer 7 months after the previous one without a worsening in transaminases. 3rd dose of Pfizer 11 months after the previous one without a worsening in transaminases |