Wu P, Sun W, Li J. Rheumatoid arthritis patients with peripheral blood cell reduction should be evaluated for latent Felty syndrome: A case report.
Medicine (Baltimore) 2020;
99:e23608. [PMID:
33371095 PMCID:
PMC7748335 DOI:
10.1097/md.0000000000023608]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 10/11/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022] Open
Abstract
RATIONALE
Felty syndrome is a rare and life-threatening type of rheumatoid arthritis (RA).
PATIENT CONCERNS
A 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).
DIAGNOSES
The 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.
INTERVENTIONS
She was given high-doses of glucocorticoids intravenously, followed by oral prednisone and cyclosporine maintenance therapy.
OUTCOMES
Her 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.
LESSONS
Felty 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.
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