Serrano Santiago Victor E, Morgan Zack
Internal Medicine, Methodist Health System, Dallas, USA.
Cureus. 2022 Apr 29;14(4):e24593. doi: 10.7759/cureus.24593. eCollection 2022 Apr.
We present a case of a 56-year-old female patient who presented to the emergency department with a one-day history of fever and confusion. She was found to have splenomegaly, multiple swan neck deformities, and pancytopenia. Chart review revealed that she had a three-year history of pancytopenia with two prior non-diagnostic bone marrow biopsies. Rheumatoid factor and cyclic citrullinated peptide antibody levels were elevated. The patient was ultimately diagnosed with Felty's syndrome (FS). Felty's syndrome is characterized by neutropenia, splenomegaly, and rheumatoid arthritis. This disease usually presents years after a diagnosis of rheumatoid arthritis is made. The neutropenia associated with Felty's syndrome can lead to life-threatening infections and therefore must be recognized so that the underlying cause of immunosuppression can be addressed.
我们报告一例56岁女性患者，她因发热和意识模糊一天就诊于急诊科。检查发现她有脾肿大、多处天鹅颈畸形和全血细胞减少。病历回顾显示她有三年全血细胞减少病史，之前曾进行过两次未明确诊断的骨髓活检。类风湿因子和环瓜氨酸肽抗体水平升高。该患者最终被诊断为费尔蒂综合征（FS）。费尔蒂综合征的特征是中性粒细胞减少、脾肿大和类风湿关节炎。这种疾病通常在类风湿关节炎确诊数年之后出现。与费尔蒂综合征相关的中性粒细胞减少可导致危及生命的感染，因此必须予以识别，以便能够解决免疫抑制的根本原因。
