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CASE REPORT
Year : 2022  |  Volume : 11  |  Issue : 4  |  Page : 161-164

Severe progression of autoimmune hepatitis in a young COVID-19 adult patient: A case report


1 Department of Trauma & Emergency, AIIMS Patna, Bihar, India, 801505, India
2 Department of Anaesthesiology, AIIMS Patna, Bihar, India, 801505, India
3 Department of Medicine, AIIMS Patna, Bihar, India, 801505, India

Correspondence Address:
Neeraj Kumar
Department of Trauma & Emergency, AIIMS Patna, Bihar, India, 801505
India
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Source of Support: This study received no extramural funding, Conflict of Interest: None


DOI: 10.4103/2221-6189.355327

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Rationale: The impact of COVID-19 in patients with autoimmune liver disease treated with immunosuppressive therapy has not been described so far. This case report describes the clinical course of a patient with autoimmune hepatitis (AIH) who developed COVID-19 and the features of cytokine syndrome leading to its deterioration in our intensive care unit. Patient’s Concern: A 28-year-old male presented with generalized anasarca for two weeks and chronic liver disease for 8 months. Diagnosis: AIH and Covid-19 with features of cytokine storm syndrome. Interventions: Intravenous furosemide, mannitol, syrup lactulose, steroids (prednisolone 40 mg), azathioprine 1 mg/kg body weight, rifaximin, vitamin K, and blood products. Outcomes: The patient had hepatic encephalopathy and AIH and died on the 10th day after admission despite ventilatory support, sustained low-efficiency hemodialysis, and resuscition. Lessons: The dramatic release of cytokines and the inflammatory-immune responses not only alter the pathophysiology but also affects the onset and severity of disease progression in patients with AIH.


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