Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can trigger autoimmune inflammation in the liver, leading to acute autoimmune hepatitis (AIH). We herein report a case involving a 39-year-old woman with a 23-day history of yellow skin and urine. Using the revised original scoring system of the International AIH Group, we definitively diagnosed the patient with acute severe AIH (AS-AIH). She began treatment with 80 mg/day intravenous methylprednisolone, which was gradually reduced and followed by eventual transition to oral methylprednisolone. The patient finally achieved a biochemical response after 30 days of therapy, and liver transplantation was avoided. Clinicians should be aware that the onset of AS-AIH after SARS-CoV-2 infection differs from the onset of conventional AIH with respect to its clinical and pathological features. Early diagnosis and timely glucocorticoid treatment are crucial in improving outcomes.

中文翻译：

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严重急性呼吸综合征冠状病毒2感染后出现急性重症自身免疫性肝炎：病例报告

严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染可引发肝脏自身免疫性炎症，导致急性自身免疫性肝炎 (AIH)。我们报告一例病例，患者为一名 39 岁女性，有 23 天皮肤和尿液发黄病史。采用国际AIH组修订后的原始评分系统，我们明确诊断该患者为急性重症AIH（AS-AIH）。她开始接受 80 毫克/天静脉注射甲基泼尼松龙治疗，逐渐减量，最终过渡为口服甲基泼尼松龙。治疗30天后，患者终于达到生化反应，避免了肝移植。临床医生应意识到，SARS-CoV-2感染后AS-AIH的发病与传统AIH的发病在临床和病理特征上有所不同。早期诊断和及时糖皮质激素治疗对于改善预后至关重要。