COVID-19 is characterized by a severe pulmonary disease due to severe acute respiratory syndrome (SARS)-CoV-2 infection. For clinicians involved in the management of patients with chronic autoimmune diseases the risk linked to the conditions itself and to drug-induced immunosuppression during the COVID-19 pandemic is a major topic. Pemphigus is a rare autoimmune blistering disease (AIBD) of the skin and mucous membranes caused by autoantibodies to desmosomal components, desmoglein 1 and 3. Among immunosuppressant therapies, rituximab (RTX) is considered a highly effective treatment with a favorable safety profile, but it induces a prolonged B-cell depletion that can lead to higher susceptibility to infections. For this reason, concerns about its use during the pandemic have been raised. We describe a case of a pemphigus patient in which RTX-induced B cell depletion led to the severe inflammatory phase, whereas corticosteroid treatment allowed a favorable outcome.
【저자키워드】 COVID-19, Immunosuppression, rituximab, B cell, pemphigus, autoimmune blistering disease, 【초록키워드】 Treatment, pandemic, susceptibility, COVID-19 pandemic, Infection, risk, outcome, Autoimmune disease, infections, management, Patient, inflammatory phase, Autoimmune, disease, safety profile, Therapies, B-cell, autoantibody, mucous membrane, acute respiratory syndrome, Topic, clinician, components, severe pulmonary disease, corticosteroid treatment, effective, Cell, caused, involved, raised, characterized, condition, induce, blistering, RTX,