• Internal medicine · Jan 2021

    Case Reports

    Discrepant Antigen-specific Antibody Responses Causing SARS-CoV-2 Persistence in a Patient Receiving B-cell-targeted Therapy with Rituximab.

    • Teruhito Takakuwa, Yu Nakagama, Mayo Yasugi, Toshiki Maeda, Kenji Matsuo, Ayako Kiritoshi, Ryo Deguchi, Naohiro Hagawa, Wataru Shibata, Kazuhiro Oshima, Katsumi Yamamoto, Kenichiro Uchida, Tomohiro Noda, Koichi Yamada, Tetsuro Nishimura, Hiromasa Yamamoto, Yasutoshi Kido, Masayuki Hino, Hiroshi Kakeya, and Yasumitsu Mizobata.
    • Department of Hematology, Graduate School of Medicine, Osaka City University, Japan.
    • Intern. Med. 2021 Jan 1; 60 (23): 3827-3831.

    AbstractA 73-year-old man previously treated with rituximab for his mucosa-associated lymphoid tissue lymphoma suffered a suboptimal humoral immune response against an acquired SARS-CoV-2 infection. A detailed serological description revealed discrepant antigen-specific humoral immune responses. The titer of spike-targeting, "viral-neutralizing" antibodies remained below the detection level, in contrast to the anti-nucleocapsid, "binding" antibody response, which was comparable in both magnitude and kinetics. Accordingly, viral neutralizability and clearance was delayed, leading to prolonged RNAemia and persistent pneumonia. The present case highlights the need to closely monitor this unique population of recipients of B-cell-targeted therapies for their neutralizing antibody responses against SARS-CoV-2.

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