%0 Journal Article %A Joana Vasconcelos %A Rita Portugal %A Rita Torres %A Sandra Falcão %T Intravenous immunoglobulin as a therapeutic option for patients with worsening COVID-19 under rituximab %D 2021 %R 10.1136/bcr-2021-243338 %J BMJ Case Reports %P e243338 %V 14 %N 6 %X Severe cases of the new COVID-19 are being reported in immunosuppressed patients. The risk seems to depend on the type of immunosuppressive agents used and it is particularly important in patients under the long-lasting effect of rituximab. Information regarding the best therapeutic approach to these patients is scarce and further studies are needed. We present a case of a young woman with rheumatoid arthritis treated with rituximab (last administration 4 months before her admission). She presented with a deteriorating and prolonged SARS-CoV-2 infection, with persistent fever, significant elevation of inflammatory markers and radiological progression. Glucocorticoids and antibiotic therapy were initiated, with no response. Intravenous immunoglobulin was then used with a rapid and exuberant response, anticipating a promising role of this therapy in immunosuppressed patients with COVID-19 under the effect of rituximab. %U https://casereports.bmj.com/content/bmjcr/14/6/e243338.full.pdf