Early onset of Felty syndrome or leukemia: A case report

Felty syndrome is a form of rheumatoid arthritis (RA) that usually presents with neutropenia and splenomegaly. It usually occurs in the setting of long-lasting (RA)and rarely as an early manifestation of RA.

A 47-year-old female patient presented to the emergency department with a history of fever and arthralgia. She was found to have splenomegaly and pancytopenia. After ruling out hematologic malignancies by bone marrow biopsies, she was diagnosed with RA. Rheumatoid factor (RF) and cyclic citrullinated peptide antibody (Anti-CCP) levels were elevated. The patient was ultimately diagnosed with early-onset Felty syndrome in the course of RAand an occult hepatitis B infection. Despite the low incidence rate of Felty syndrome, it should be considered as a differential diagnosis of patients with arthralgia, fever, neutropenia, and splenomegaly.