Felty's syndrome presenting without arthritis

Area of Science:

• Rheumatology
• Hematology

Background:

• Felty's syndrome is a rare autoimmune condition characterized by rheumatoid arthritis, splenomegaly, and neutropenia.
• Diagnosis can be challenging due to variable clinical presentations.

Observation:

• A patient presented with splenomegaly and severe granulocytopenia, alongside a positive rheumatoid factor, but initially lacked rheumatoid arthritis symptoms.
• Leukopenia resolved post-splenectomy and remained stable during follow-up.

Findings:

• Symmetrical metacarpophalangeal joint swelling emerged nine months after initial presentation.
• This case highlights arthritis as a potential late and subtle manifestation of Felty's syndrome.

Implications:

• Clinicians should consider Felty's syndrome in patients with unexplained splenomegaly and cytopenias, even without overt arthritis.
• Early recognition and management are crucial for preventing complications associated with Felty's syndrome.