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Massive Splenomegaly in Felty's Syndrome: A Case Report
Laura N Soares1, Juliana M Sternlicht1, Nicole Jensen1
1Internal Medicine, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BRA.
Felty's syndrome (FS), a rare rheumatoid arthritis complication, presents diagnostic challenges. Early recognition of FS, even without prior RA history, is key for improved patient outcomes.
Area of Science:
- Rheumatology
- Hematology
- Internal Medicine
Background:
- Felty's syndrome (FS) is a rare triad of rheumatoid arthritis (RA), splenomegaly, and neutropenia.
- Diagnosis is challenging due to overlapping symptoms with other hematologic and autoimmune disorders.
Observation:
- A 47-year-old male presented with weight loss, polyarthralgia, splenomegaly, and anemia, initially suspected as hematologic malignancy.
- Elevated beta-2-microglobulin and positive antinuclear antibodies were noted; malignancy and schistosomiasis were ruled out.
Findings:
- The patient was diagnosed with Felty's syndrome.
- Treatment with prednisone, filgrastim, and methotrexate resulted in significant clinical improvement, including reduced joint pain, spleen size, and ulcer healing.
Implications:
- This case highlights the diagnostic complexity of FS, particularly when RA is not previously diagnosed.
- FS should be considered in unexplained splenomegaly and neutropenia, even without a history of RA.
- Prompt diagnosis and treatment are crucial for favorable patient outcomes.
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