The development of autoimmune diseases has been reported after SARS-CoV-2 infection. Vaccination against SARS-CoV-2 could also trigger auto-immunity, as it has been described with other vaccines. An aberrant immune response induced by molecular mimicry and bystander activation, especially in predisposed individuals, is a potential mechanism. We report the case of a 76-year-old woman with Hashimoto thyroiditis and prior COVID-19 infection who developed severe autoimmune hepatitis (with typical features including strongly positive anti-smooth muscle antibody and markedly elevated immunoglobulins G, as well as typical histological findings) following SARS-CoV-2 vaccination (mRNA-1273 SARS-CoV-2 vaccine, Moderna®). The link between SARS-CoV-2 vaccination and the development of autoimmune diseases needs to be further investigated. Although a causality relationship cannot be proven, caution may be warranted when vaccinating individuals with known autoimmune diseases.

据报道，感染 SARS-CoV-2 后会出现自身免疫性疾病。正如其他疫苗所描述的那样，针对 SARS-CoV-2 的疫苗也可能引发自身免疫。由分子拟态和旁观者激活引起的异常免疫反应，特别是在易感个体中，是一种潜在的机制。我们报道了一名患有桥本甲状腺炎且既往感染过 COVID-19 的 76 岁女性患者，她出现了严重的自身免疫性肝炎（典型特征包括抗平滑肌抗体强阳性和免疫球蛋白 G 显着升高，以及典型的组织学发现） ）接种 SARS-CoV-2 疫苗（mRNA-1273 SARS-CoV-2 疫苗，Moderna®）后。SARS-CoV-2 疫苗接种与自身免疫性疾病发展之间的联系需要进一步研究。