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## Multiple drugs Humoral immunodeficiency, lack of efficacy and off-label use: case report A 52-year-old woman developed humoral immunodeficiency during treatment with hydroxychloroquine, methotrexate and rituximab for multiple autoimmune syndrome (MAS) presenting as systemic lupus erythematosus and rheumatoid arthritis. Subsequently, she exhibited lack of efficacy during an off-label treatment with prednisone for COVID-19. She additionally received an off-label treatment with azithromycin and convalescent-anti-SARS-CoV-2-plasma for Covid-19 [routes, dosages and durations of treatments to reaction onset not stated]. The woman presented to the emergency department (ED) with a 3-day history of flu-like symptoms. Medical history was significant for MAS presenting as systemic lupus erythematosus and rheumatoid arthritis, under immunosuppressive treatment with rituximab infusion every 5-6 months, methotrexate weekly and hydroxychloroquine daily. At the current presentation, a nasopharyngeal fluid PCR tested positive for SARS-CoV-2 along with lower lung infiltrates. She was discharged from the ED with an off-label azithromycin dose pack. She eventually returned to the ED with hypoxia an

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Publisher

Springer Science and Business Media LLC

Published

2023

Language

EN

Field

Medicine (Health Sciences)