The First Affiliated Hospital of GuangDong Pharmaceutical University.
Department of traditional Chinese medicine, southern theater general hospital, the Chinese People's Liberation Army, Guangzhou, China.
Medicine (Baltimore). 2020 Dec 18;99(51):e23608. doi: 10.1097/MD.0000000000023608.
Felty syndrome is a rare and life-threatening type of rheumatoid arthritis (RA).
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).
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.
She was given high-doses of glucocorticoids intravenously, followed by oral prednisone and cyclosporine maintenance therapy.
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.
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.
费尔蒂综合征是一种罕见且危及生命的类风湿关节炎（RA）类型。
一位 RA 患者出现皮疹和皮下出血，血红蛋白（Hb）、白细胞计数（WBC）和血小板计数（BPC）显著下降。
患者有 RA 病史、脾肿大、Hb、WBC、BPC 减少和正常免疫指标，结合一系列骨髓相关检查和基因检查。
给予患者大剂量静脉注射糖皮质激素，随后口服泼尼松和环孢素维持治疗。
免疫抑制开始后 2 周内患者症状得到缓解。出院后 2 周，Hb、WBC、BPC 基本恢复正常，泼尼松逐渐减少。
费尔蒂综合征是 RA 的罕见并发症。Hb、WBC、BPC 减少和皮下出血应强烈考虑为费尔蒂综合征的可能性。骨髓和基因的多学科诊断和相关检查有助于诊断和正确治疗。
