A 60-year-old woman with a 20-year history of seropositive rheumatoid arthritis presents with recurrent infections. Examination reveals splenomegaly (4 cm below costal margin) and neutropenia with an absolute neutrophil count of 600/mm3. Platelet count and hemoglobin are normal. What is the diagnosis?
- A Methotrexate-induced myelosuppression
- B Felty syndrome ✓
- C T-cell large granular lymphocytic leukemia
- D Aplastic anemia
Correct answer: B. Felty syndrome
Explanation
Felty syndrome is the triad of seropositive RA, splenomegaly, and neutropenia. It typically occurs in long-standing seropositive disease. Methotrexate can cause pancytopenia but not isolated neutropenia with splenomegaly. T-LGL leukemia can mimic Felty syndrome but lacks the specific RA association. Aplastic anemia causes pancytopenia without splenomegaly.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.