Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2022; 10(26): 9384-9389
Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9384
Single organ hepatic artery vasculitis as an unusual cause of epigastric pain: A case report
Rojin Kaviani, Jessica Farrell, Natasha Dehghan, Sarvee Moosavi
Rojin Kaviani, Internal Medicine, University of British Columbia, Vancouver V5Z 1M9, British Columbia, Canada
Jessica Farrell, Division of Radiology, Providence Health Care, Vancouver V5T 3N4, British Columbia, Canada
Natasha Dehghan, Division of Rheumatology, Providence Health Care, Vancouver V5T 3N4, British Columbia, Canada
Sarvee Moosavi, Division of Gastroenterology, University of British Columbia, Vancouver V6Z 2K5, British Columbia, Canada
Author contributions: Kaviani R, Moosavi S, Dehghan N and Farrell J contributed to data acquisition, drafting and revision of the final version; Kaviani R wrote the paper; Moosavi S generated the case and final approval.
Informed consent statement: Informed patient consent was obtained for publication of the case.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Rojin Kaviani, BSc, MD, Doctor, Internal Medicine, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, 3rd Floor-2775 Laurel Street, Vancouver V5Z 1M9, British Columbia, Canada.
Received: April 11, 2022
Peer-review started: April 11, 2022
First decision: June 8, 2022
Revised: July 7, 2022
Accepted: August 1, 2022
Article in press: August 1, 2022
Published online: September 16, 2022

Single-organ vasculitis (SOV) is characterized by inflammation of a blood vessel, affecting one organ, such as the skin, genitourinary system, or the aorta without systemic features. Gastrointestinal SOV is rare, with hepatic artery involvement reported only in two prior published cases. Herein, we presented a case of isolated hepatic artery vasculitis presenting after Pfizer-BioNTech mRNA corona virus disease 2019 (COVID-19) vaccination.


A 50-year-old woman with hypertension presented to our Emergency Department with recurrent diffuse abdominal pain that localized to the epigastrium and emesis without diarrhea that began eight days after the second dose of the Pfizer-BioNTech COVID-19 vaccine. Blood work revealed an elevated C-reactive protein (CRP) of 19 mg/L (normal < 4.8 mg/L), alkaline phosphatase 150 U/L (normal 25-105 U/L), gamma-glutamyl transferase (GGT) 45 U/L (normal < 43 U/L) and elevated immunoglobulins (Ig) G 18.4 g/L (normal 7-16 g/L) and IgA 4.4 g/L (normal 0.7-4 g/L). An abdominal computed tomography revealed findings in keeping with hepatic artery vasculitis. A detailed review of her history and examination did not reveal infectious or systemic autoimmune causes of her presentation. An extensive autoimmune panel was unremarkable. COVID-19 polymerase chain reaction nasopharyngeal swab, human immunodeficiency virus, viral hepatitis and Heliobacter pylori serology were negative. At six months, the patient’s symptoms, and blood work spontaneously normalized.


High clinical suspicion of SOV is required for diagnosis in patients with acute abdominal pain and dyspepsia.

Keywords: Single organ vasculitis, Hepatic artery, gastrointestinal vasculitis, COVID-19 vaccine, Hepatic artery vasculitis, Case report

Core Tip: Single organ vasculitis (SOV) of the gastrointestinal (GI) tract is uncommon with hepatic artery involvement rarely reported. It presents with abdominal pain and often without changes in inflammatory or other biomarkers. It is diagnosed radiographically or incidentally via surgical specimens. mRNA coronavirus disease 2019 (COVID-19) vaccines have been stipulated to contribute to inflammatory side- effects such as myocarditis, and autoimmune hepatitis. The diagnosis of GI SOV should be considered as a potential cause of acute abdominal pain following COVID-19 mRNA vaccination.