Abstract
A Case of Drug-Induced Cholestatic Hepatitis After Moderna COVID 19 Vaccination
Jose Maria Gonzalez1, Angelo Jonathan Cruz1
1Section of Gastroenterology and Liver Unit, Makati Medical Center
Significance: The COVID-19 pandemic has caused significant morbidity and mortality worldwide. Several therapeutic options have been developed to reduce the disease severity, one of which are vaccines. Drug-induced liver injury is a known adverse effect of vaccines, however there are only a few reported cases of liver injury from COVID-19 vaccines.
Clinical Presentation: This study presents a patient that developed jaundice, abdominal pain, and nausea 2 weeks after receiving her first COVID-19 booster dose with the Moderna vaccine. No identified intake of hepatotoxic drug or herbal medication.
Management: Initial liver enzymes showed SGPT 530 U/L, SGOT 88 U/L, Total Bilirubin 7.07 mg/dl. Work up was negative for viral and autoimmune hepatitis and hemochromatosis. A 1.2x1.2 cm hemangioma was seen on MRCP. Liver biopsy showed zone two ballooning degeneration and was signed out as cholestatic hepatitis, favoring drug induced liver injury. Patient was started on Ursodeoxycholic Acid 500 mg 2x/day and further COVID-19 booster doses were discontinued. On follow after one month, patient was no longer jaundiced with improving liver enzymes.
Recommendation: This case report shows a potential side effect of the COVID-19 vaccination that should be a consideration in patients. Despite this, vaccination for COVID-19 is still highly recommended and regarded as effective and safe.
Keywords: COVID-19 vaccine, Drug Induced Liver Injury
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
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| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |