Mild COVID-19 in ANCA-associated vasculitis treated with rituximab

Treatment for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis usually raises questions about the risk of infections. Particular attention has been given to the impact of drugs such as cyclophosphamide and B-cell depletory therapies on the severity of COVID-19. Monti et al 1 suggest that receiving biological disease-modifying antirheumatic drugs may not increase risk of COVID-19. Furthermore, Guilpain et al 2 reported a woman treated with rituximab and low-dose prednisone due to granulomatosis with polyangeitis proteinase 3- anti-neutrophil cytoplasmic antibody (PR3-ANCA) vasculitis, who developed pneumonia associated with COVID-19 with a milder evolution than expected in other series. Here, we present a 64-year-old woman diagnosed of myeloperoxidase-ANCA microscopic polyangiitis in 2014, with secondary hypertrophic pachymeningitis, sinusitis and constitutional syndrome. Her main comorbidities were hypercholesterolaemia and areata alopecia. On 25 November 2019, vasculitis relapsed and was treated with two infusions of 1000 mg rituximab given 2 weeks apart, in …