A 62-year-old woman with long-standing seropositive rheumatoid arthritis presents with fatigue, weight loss, and recurrent infections. Examination reveals splenomegaly and leg ulcers. Blood tests show hemoglobin 10.2 g/dL, WBC 1,800/μL, and platelets 85,000/μL. Which triad defines this syndrome?

• A RA, uveitis, urethritis
• B RA, fever, salmon-colored rash
• C RA, Raynaud phenomenon, sclerosis
• D RA, splenomegaly, neutropenia ✓

Explanation

Felty syndrome is the triad of RA, splenomegaly, and neutropenia with ANC less than 1,500/μL. It occurs in seropositive RA patients and leads to recurrent infections. Option A describes reactive arthritis. Option C describes CREST syndrome. Option B describes systemic-onset JIA.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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