Presumed Cytokine-Mediated Mild Liver Injury With Similar Kinetics Following COVID-19, Acute Prostatitis, and mRNA Vaccination: A Case Report and Review of the Literature

TL;DR

A 72-year-old man experienced similar mild liver injuries after three different inflammatory events, suggesting a possible individual susceptibility to cytokine-mediated liver damage.

Contribution

The paper highlights a potential host-specific predisposition to cytokine-mediated liver injury in response to various inflammatory stimuli.

Findings

Liver enzyme elevations followed by normalization occurred after each inflammatory event.

mRNA vaccination was associated with transient increases in IL-6 and tumor necrosis factor alpha.

The consistent pattern suggests a possible individual susceptibility to cytokine-mediated liver injury.

Abstract

Cytokine-mediated liver injury is well-documented in severe systemic inflammatory conditions, such as cytokine storms. However, its occurrence in mild inflammatory settings remains underrecognized and is rarely monitored longitudinally in a single individual. The author presents his own case involving recurrent episodes of transient, mild liver injury occurring in himself as a 72-year-old man. These episodes were temporally associated with three distinct inflammatory stimuli: COVID-19, acute prostatitis, and administration of a SARS-CoV-2 mRNA vaccine. Liver function tests performed during each event showed similar patterns of elevation followed by normalization. After mRNA vaccination, monitoring revealed a transient increase in proinflammatory cytokines, specifically IL-6 and tumor necrosis factor alpha, that coincided with the elevation of liver enzymes. The recurrence of this distinct pattern of mild liver injury suggests a potential host-specific predisposition to cytokine-mediated injury in response to various inflammatory stimuli. This observation warrants further investigation to clarify the pathophysiology and clinical significance of such mild reactions.

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