Neutropaenia and splenomegaly without arthritis: think rheumatoid arthritis. (11th July 2018)

• Record Type: Journal Article
• Authors: Aslam, Fawad; Cheema, Rabia S; Feinstein, Michael; Chang-Miller, April
• Is Part Of: BMJ case reports. Volume 2018
• Publication Date: 2018-07-11
• Subjects: rheumatoid arthritis -- haematology (incl blood transfusion); Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-225359
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Felty syndrome(FS) is an uncommon, but severe, extra-articular manifestation of rheumatoid arthritis (RA). It occurs in patients with longstanding RA. It is extremely rare for RA to present as FS or develop after initially presenting as neutropaenia and splenomegaly. We describe a case of 47-year-old woman who was diagnosed simultaneously with FS and possible RA after testing positive for anticyclic citrullinated peptide antibody, but a negative rheumatoid factor. She had an excellent response to methotrexate. We review the existing literature of such cases and emphasise the importance of serological testing for RA in patients presenting with neutropaenia and splenomegaly, even in the absence of joint symptoms or prior diagnosis of RA.