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COVID-19 pneumonia in a patient with granulomatosis with polyangiitis on rituximab: case-based review.
Rodriguez-Pla, Alicia; Vikram, Holenarasipur R; Khalid, Vanood; Wesselius, Lewis J.
  • Rodriguez-Pla A; Division of Rheumatology, Mayo Clinic Arizona, Scottsdale, AZ, USA. rodriguezpla.alicia@mayo.edu.
  • Vikram HR; Division of Infectious Diseases, Mayo Clinic Arizona, Phoenix, AZ, USA.
  • Khalid V; Division of Hospital Internal Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA.
  • Wesselius LJ; Division of Pulmonary and Critical Care Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA.
Rheumatol Int ; 41(8): 1509-1514, 2021 08.
Article in English | MEDLINE | ID: covidwho-1258195
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Granulomatosis with Polyangiitis / Rituximab / SARS-CoV-2 / COVID-19 / Immunosuppressive Agents Type of study: Case report / Diagnostic study / Prognostic study Limits: Aged / Humans / Male Language: English Journal: Rheumatol Int Year: 2021 Document Type: Article Affiliation country: S00296-021-04905-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Granulomatosis with Polyangiitis / Rituximab / SARS-CoV-2 / COVID-19 / Immunosuppressive Agents Type of study: Case report / Diagnostic study / Prognostic study Limits: Aged / Humans / Male Language: English Journal: Rheumatol Int Year: 2021 Document Type: Article Affiliation country: S00296-021-04905-4