# COVID-19 Challenges in Autoimmune Hepatitis Management: A Successful Outcome With Intravenous Immune Globulin (IVIg)

## TL;DR

A 9-year-old boy with autoimmune hepatitis and COVID-19 showed improvement after treatment with intravenous immune globulin.

## Contribution

Demonstrates successful use of IVIg in managing autoimmune hepatitis alongside COVID-19 in a pediatric case.

## Key findings

- IVIg treatment led to a decline in liver enzymes and bilirubin levels in a patient with AIH and COVID-19.
- The patient showed improvement after not responding to corticosteroids.
- This case suggests IVIg could be a viable therapeutic option for AIH concurrent with COVID-19.

## Abstract

Background: Several autoimmune diseases, such as autoimmune hepatitis (AIH), can arise or become decompensated following COVID-19 infection or vaccination; however, there is a lack of data regarding the management of concurrent COVID-19 infection and autoimmune diseases.

Case Summary: In this paper, we present a case of a 9-year-old boy with yellowish discoloration of the skin and sclera, abnormal liver function test, followed by positive qRT-PCR for SARS-CoV-2 and progressive bicytopenia. After a lack of response to corticosteroids, intravenous immune globulin (IVIg) was administrated and a decline in liver enzymes, total bilirubin, and direct bilirubin was observed.

Result and Discussion: This case illustrates how IVIg significantly improved the AIH symptoms in the patient with positive qRT-PCR for the SARS-CoV-2 test. We hope our report encourages further research on therapeutic approaches for AIH concomitant with COVID-19.