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

tetano

Editor, Senior Moderator
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[SUP] 1 [/SUP], Jorge Garcia Borrega[SUP] 1 [/SUP], Laura Beckmann[SUP] 1 [/SUP], Julia Neuhann[SUP] 2 [/SUP], Birgit S Gathof[SUP] 2 [/SUP], Veronica Di Cristanziano[SUP] 3 [/SUP], Henning Hagmann[SUP] 4 [/SUP], Garcia Borrega[SUP] 2 [/SUP]



Affiliations

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.
 
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