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COVID-19 pneumonia in a patient with granulomatosis with polyangiitis on rituximab: case-based review.
- Source :
-
Rheumatology international [Rheumatol Int] 2021 Aug; Vol. 41 (8), pp. 1509-1514. Date of Electronic Publication: 2021 Jun 06. - Publication Year :
- 2021
-
Abstract
- A 77-year-old man with past medical history of granulomatosis with polyangiitis (GPA) on rituximab and prednisone, presented to the hospital with worsening cough and shortness of breath. He had tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by nasal swab polymerase chain reaction (PCR) while asymptomatic, 6 weeks earlier. He started with cough and shortness of breath 2 weeks after his initial positive test. After developing symptoms, he tested negative twice by nasal swab PCR, but the PCR of his bronchioloalveolar lavage was positive for SARS-CoV-2. He did not develop antibodies against coronavirus. Prednisone 15 mg daily was continued, and he received remdesivir, and convalescent plasma with quick recovery. We reviewed the literature to search for similar cases. Our case suggests that SARS-CoV-2 infection in patients on rituximab may have an atypical presentation and the diagnosis may be delayed due to negative PCR testing in the nasal swab. Patients may benefit from treatment with convalescent plasma.
- Subjects :
- Aged
COVID-19 diagnosis
COVID-19 immunology
COVID-19 therapy
Granulomatosis with Polyangiitis diagnosis
Granulomatosis with Polyangiitis immunology
Host-Pathogen Interactions
Humans
Immunization, Passive
Immunocompromised Host
Male
SARS-CoV-2 immunology
Treatment Outcome
COVID-19 Drug Treatment
COVID-19 Serotherapy
COVID-19 virology
Granulomatosis with Polyangiitis drug therapy
Immunosuppressive Agents adverse effects
Rituximab adverse effects
SARS-CoV-2 pathogenicity
Subjects
Details
- Language :
- English
- ISSN :
- 1437-160X
- Volume :
- 41
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Rheumatology international
- Publication Type :
- Academic Journal
- Accession number :
- 34091704
- Full Text :
- https://doi.org/10.1007/s00296-021-04905-4