Case Report: Complete and Fast Recovery From Severe COVID-19 in a Pemphigus Patient Treated With Rituximab

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 CO...

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Bibliographic Details
Published in:Frontiers in immunology 2021-04, Vol.12, p.665522
Main Authors: Sinagra, Jo Linda, Vedovelli, Claudio, Binazzi, Raffaella, Salemme, Adele, Moro, Francesco, Mazzanti, Cinzia, Didona, Biagio, Di Zenzo, Giovanni
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - adverse effects
Adrenal Cortex Hormones - therapeutic use
autoimmune blistering disease
B cell
B-Lymphocytes - immunology
B-Lymphocytes - metabolism
COVID-19
COVID-19 - complications
COVID-19 - physiopathology
COVID-19 Drug Treatment
Female
Fever
Humans
Immunoglobulin G - immunology
Immunology
immunosuppression
Inflammation - drug therapy
Middle Aged
Oxygen Inhalation Therapy
pemphigus
Pemphigus - complications
Pemphigus - drug therapy
Pemphigus - immunology
rituximab
Rituximab - adverse effects
Rituximab - therapeutic use
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Summary: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.
ISSN:1664-3224
1664-3224
DOI:10.3389/fimmu.2021.665522