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.
【저자키워드】 COVID-19, SARS-CoV-2, Immunosuppression, rituximab, Vasculitis, Autoimmune rheumatic disease, Immunosuppressive treatment, B cell depletion, Granulomatosis with polyangiitis, GPA, 【초록키워드】 Treatment, severe acute respiratory syndrome coronavirus 2, convalescent plasma, coronavirus, antibody, SARS-COV-2 infection, hospital, Infection, Diagnosis, Remdesivir, severe acute respiratory syndrome Coronavirus, cough, Symptoms, rituximab, polymerase chain reaction, PCR testing, PCR, Asymptomatic, Patient, Prednisone, nasal swab, Atypical, Granulomatosis with polyangiitis, medical history, Chain Reaction, Shortness of breath, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, Positive test, Negative PCR, positive, past medical history, worsening cough, benefit, polymerase chain, initial, granulomatosis, polyangiitis, tested, develop, 【제목키워드】 Pneumonia, Patient, Granulomatosis with polyangiitis,