• Medicine · Dec 2020

    Case Reports

    Rheumatoid arthritis patients with peripheral blood cell reduction should be evaluated for latent Felty syndrome: A case report.

    • Peng Wu, Weifeng Sun, and Jing Li.
    • The First Affiliated Hospital of GuangDong Pharmaceutical University.
    • Medicine (Baltimore). 2020 Dec 18; 99 (51): e23608.

    RationaleFelty syndrome is a rare and life-threatening type of rheumatoid arthritis (RA).Patient ConcernsA patient with RA had skin rash and subcutaneous hemorrhage, with a significant decrease in blood hemoglobin (Hb), white blood cell count (WBC), and blood platelet count (BPC).DiagnosesThe patient had a history of RA, splenomegaly, decreased Hb, WBC, BPC, and normal immunological indexes, combined with a series of bone marrow related tests and genetic tests.InterventionsShe was given high-doses of glucocorticoids intravenously, followed by oral prednisone and cyclosporine maintenance therapy.OutcomesHer symptoms were resolved within 2 weeks after the start of immunosuppression. After 2 weeks of discharge, the Hb, WBC, BPC basically returned to normal, and prednisone gradually decreased.LessonsFelty syndrome is a rare complication of RA. Reductions in Hb, WBC, BPC, and subcutaneous hemorrhage should be considered strongly as the possibility of Felty syndrome. Multi-disciplinary diagnosis and related tests of bone marrow and genes are helpful for diagnosis and correct treatment.Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.

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