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  • Persistence of rT-PCR-SARS-CoV-2 infection and delayed serological response, as a possible effect of rituximab according to the hypothesis of Schulze-Koops et al

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Correspondence
Persistence of rT-PCR-SARS-CoV-2 infection and delayed serological response, as a possible effect of rituximab according to the hypothesis of Schulze-Koops et al
  1. Maurizio Benucci1,
  2. Luca Quartuccio2,
  3. Francesca Li Gobbi3,
  4. Arianna Damiani4,
  5. Valentina Grossi5,
  6. Maria Infantino6,
  7. Mariangela Manfredi7
  1. 1 Rheumatology Unit, Ospedale San Giovanni di Dio, Firenze, Toscana, Italy
  2. 2 Internal Medicie and Rheumatology Unit University of Udine, Udine, Italy
  3. 3 Rheumatology Unit, Ospedale San Giovanni di Dio Hospital, Florence, Italy
  4. 4 Rheumatology Unit Department Experimental Medicine University of Florence, Florence, Italy
  5. 5 Maria Infantino Mariangela Manfredi Laboratory of Immunology and Allergology SGiovanni di Dio Hospital, Florence, Italy
  6. 6 Laboratory of Immunology and Allergology, Ospedale San Giovanni di Dio, Firenze, Italy
  7. 7 Ospedale San Giovanni di Dio, Firenze, Italy
  1. Correspondence to Dr Maurizio Benucci, Rheumatology Unit, Ospedale San Giovanni di Dio, Firenze, Toscana, Italy; maubenucci{at}tiscali.it

https://doi.org/10.1136/annrheumdis-2020-218590

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    The large study of 600 cases from 40 countries of the Covid-Global Rheumatology Alliance has shown that the use of conventional disease-modifying antirheumatic drug, alone or in combination with biologics/Janus Kinase inhibitors, and tumour necrosis factor inhibitor was associated with a reduced odds of hospitalisation.1 Schulze-Koops et al described two fatal outcomes in patients with rheumatoid arthritis treated with rituximab and focuses on careful vigilance on immunosuppression in the treatment of immune-mediated rheumatic diseases.2 To reinforce this observation, we report the case of a female patient aged about 60 years old, with a history of polymyositis and Sjögren’s syndrome. Her history was significant for previous cancer: thyroid carcinoma in 1995, phylloid tumour of the right breast in 2010 and carcinoid of the annexes in 2011. In January 2020, the patient had problem of fatigue, myalgia, together with rise in creatinekinase (CK) and Aldolase with positive anti-Mi-2 antibody, while on stable maintenance treatment with methotrexate 12.5 mg/weekly and prednisone 10 mg/day, rituximab 1 g 2 weeks apart was employed since 2017 with further cycles on the basis of …

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    Footnotes

    • Contributors MB collected the patient data and wrote the manuscript. LQ contributed the revision of the manuscript. FLG collected the patient data. AD contributed the revision of the manuscript. VG, MI and MM determined the laboratory values.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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