TY - JOUR T1 - Intravenous immunoglobulin as a therapeutic option for patients with worsening COVID-19 under rituximab JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2021-243338 VL - 14 IS - 6 SP - e243338 AU - Joana Vasconcelos AU - Rita Portugal AU - Rita Torres AU - Sandra Falcão Y1 - 2021/06/01 UR - http://casereports.bmj.com/content/14/6/e243338.abstract N2 - 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. ER -