Case Report
Felty's Syndrome as an initial presentation of Rheumatoid Arthritis: a case report
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* Corresponding author: Andrey Iliev Andrey.Iliev@nbhn.net
1 Department of Internal Medicine, James J Peters Veterans Affairs Medical Center, Mount Sinai School of Medicine Program, 130 W Kingsbridge Road, Bronx, NY 10468, New York, USA
2 Department of Internal Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA
3 Department of Internal Medicine, North Central Bronx Hospital, New York City Health and Hospitals Corporation, 3424 Kossuth Avenue, Bronx, NY 10467, New York, USA
Cases Journal 2009, 2:206 doi:10.1186/1757-1626-2-206
Published: 18 November 2009Abstract
Introduction
Felty's syndrome is an uncommon but severe extra-articular manifestation of rheumatoid arthtitis. Felty's syndrome is characterized by the triad of rheumatoid arthtitis, neutropenia, and splenomegaly. The lifetime risk of Felty's syndrome for a rheumatoid arthtitis patient is less than 1% and there are only few case reports of Felty's syndrome with neutropenia preceded clinical evidence of arthritis. We present a case which is atypical presentation of Felty's syndrome without arthritis.
Case presentation
We present a case of 31-year-old man who presented with fever and skin infection, found to have neutropenia. The work up showed splenomegaly and other evidences support Felty's syndrome diagnosis without arthritis presentation.
Conclusion
Patients with unexplained, continuous neutropenia without arthristis but with high level of rheumatoid factor and positive antibodies to cyclic citrullinated peptides should be suspected of developing Felty's syndrome as an initial presentation of rheumatoid arthtitis.