Clin Kidney J . Plasma exchange with COVID-19 convalescent plasma in a patient with severe ANCA-associated vasculitis and COVID-19 pneumonia after rituximab therapy

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Clin Kidney J


. 2021 May 27;15(1):162-164.
doi: 10.1093/ckj/sfab095. eCollection 2022 Jan.
Plasma exchange with COVID-19 convalescent plasma in a patient with severe ANCA-associated vasculitis and COVID-19 pneumonia after rituximab therapy


Matthias Kochanek ¹ , Jorge Garcia Borrega ¹ , Laura Beckmann ¹ , Julia Neuhann ² , Birgit S Gathof ² , Veronica Di Cristanziano ³ , Henning Hagmann ⁴ , Garcia Borrega ²



Affiliations

• PMID: 35028131
• PMCID: PMC8244539
• DOI: 10.1093/ckj/sfab095

Abstract

The combination of coronavirus disease 2019 (COVID-19) pneumonia and pulmonary-renal syndrome due to ANCA-associated vasculitis (AAV) poses diagnostic uncertainty and a therapeutic dilemma. According to current limited knowledge of COVID-19, the application of commonly used drugs in AAV, cyclophosphamide (CYC) and rituximab (RTX), must be weighed carefully in active COVID-19 infection. We report a case of a 52-year-old male patient with concurrent severe COVID-19 pneumonia and acute relapse of pulmonary-renal syndrome due to AAV after recent RTX maintenance dose. The patient presented with severe hypoxaemia, complete B-cell depletion and severe acute respiratory syndrome coronavirus 2 viraemia. He was successfully treated with therapeutic plasma exchange employing COVID-19 convalescent plasma.

Keywords: ANCA vasculitis; SARS-CoV-2; intensive care; plasma exchange; plasmapheresis; pneumonia; rituximab.