dc.contributor.author |
Efe, C. |
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dc.contributor.author |
Kulkarni, A.V. |
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dc.contributor.author |
Terziroli Beretta-Piccoli, B. |
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dc.contributor.author |
Magro, B. |
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dc.contributor.author |
Friedrich Stättermayer, A. |
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dc.contributor.author |
Cengiz, M. |
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dc.contributor.author |
Clayton-Chubb, D. |
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dc.contributor.author |
Lammert, C. |
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dc.contributor.author |
Bernsmeier, C. |
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dc.contributor.author |
Gül, Ö. |
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dc.contributor.author |
la Tijera, F.H.-D. |
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dc.contributor.author |
Anders, M. |
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dc.contributor.author |
Lytvyak, E. |
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dc.contributor.author |
Akın, M. |
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dc.contributor.author |
Purnak, T. |
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dc.contributor.author |
Liberal, R. |
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dc.contributor.author |
Peralta, M. |
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dc.contributor.author |
Ebik, B. |
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dc.contributor.author |
Duman, S. |
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dc.contributor.author |
Demir, N. |
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dc.contributor.author |
Balaban, Y. |
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dc.contributor.author |
Urzua, Á. |
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dc.contributor.author |
Contreras, F. |
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dc.contributor.author |
Venturelli, M.G. |
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dc.contributor.author |
Bilgiç, Y. |
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dc.contributor.author |
Medina, A. |
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dc.contributor.author |
Girala, M. |
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dc.contributor.author |
Günşar, F. |
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dc.contributor.author |
Londoño, M.-C. |
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dc.contributor.author |
Androutsakos, T. |
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dc.contributor.author |
Kisch, A. |
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dc.contributor.author |
Yurci, A. |
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dc.contributor.author |
Güzelbult, F. |
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dc.contributor.author |
Çağın, Y.F. |
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dc.contributor.author |
Avcı, E. |
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dc.contributor.author |
Güzelbulut, M. |
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dc.contributor.author |
Dindar-Demiray, E.K. |
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dc.contributor.author |
Harputluoğlu, M. |
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dc.contributor.author |
Kumar, R. |
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dc.contributor.author |
Satapathy, S.K. |
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dc.contributor.author |
Mendizabal, M. |
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dc.contributor.author |
Silva, M. |
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dc.contributor.author |
Fagiuoli, S. |
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dc.contributor.author |
Roberts, S.K. |
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dc.contributor.author |
Soylu, N.K. |
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dc.contributor.author |
Idilman, R. |
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dc.contributor.author |
Yoshida, E.M. |
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dc.contributor.author |
Montano-Loza, A.J. |
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dc.contributor.author |
Dalekos, G.N. |
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dc.contributor.author |
Ridruejo, E. |
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dc.contributor.author |
Schiano, T.D. |
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dc.contributor.author |
Wahlin, S. |
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dc.date.accessioned |
2022-10-06T12:54:50Z |
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dc.date.available |
2022-10-06T12:54:50Z |
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dc.date.issued |
2022 |
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dc.identifier.issn |
02709139 (ISSN) |
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dc.identifier.uri |
http://hdl.handle.net/11616/72472 |
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dc.description.abstract |
Background and Aims: A few case reports of autoimmune hepatitis–like liver injury have been reported after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. We evaluated clinical features, treatment response and outcomes of liver injury following SARS-CoV-2 vaccination in a large case series. Approach and Results: We collected data from cases in 18 countries. The type of liver injury was assessed with the R-value. The study population was categorized according to features of immune-mediated hepatitis (positive autoantibodies and elevated immunoglobulin G levels) and corticosteroid therapy for the liver injury. We identified 87 patients (63%, female), median age 48 (range: 18–79) years at presentation. Liver injury was diagnosed a median 15 (range: 3–65) days after vaccination. Fifty-one cases (59%) were attributed to the Pfizer-BioNTech (BNT162b2) vaccine, 20 (23%) cases to the Oxford-AstraZeneca (ChAdOX1 nCoV-19) vaccine and 16 (18%) cases to the Moderna (mRNA-1273) vaccine. The liver injury was predominantly hepatocellular (84%) and 57% of patients showed features of immune-mediated hepatitis. Corticosteroids were given to 46 (53%) patients, more often for grade 3–4 liver injury than for grade 1–2 liver injury (88.9% vs. 43.5%, p = 0.001) and more often for patients with than without immune-mediated hepatitis (71.1% vs. 38.2%, p = 0.003). All patients showed resolution of liver injury except for one man (1.1%) who developed liver failure and underwent liver transplantation. Steroid therapy was withdrawn during the observation period in 12 (26%) patients after complete biochemical resolution. None had a relapse during follow-up. Conclusions: SARS-CoV-2 vaccination can be associated with liver injury. Corticosteroid therapy may be beneficial in those with immune-mediated features or severe hepatitis. Outcome was generally favorable, but vaccine-associated liver injury led to fulminant liver failure in one patient. © 2022 American Association for the Study of Liver Diseases. |
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dc.source |
Hepatology |
|
dc.title |
Liver injury after SARS-CoV-2 vaccination: Features of immune-mediated hepatitis, role of corticosteroid therapy and outcome |
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